| 5th Ave Dental Inc. | |
|
1619 W 5th Ave Gary IN 46404-1506 | |
| (708) 359-2068 | |
| Not Available |
| Full Name | 5th Ave Dental Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1619 W 5th Ave, Gary, Indiana |
| Authorized Official Name and Position | Amit Saparia (PRESIDENT) |
| Authorized Official Contact | 7083592068 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 5th Ave Dental Inc. 814 W Chicago Ave East Chicago IN 46312-3307 Ph: () - | 5th Ave Dental Inc. 1619 W 5th Ave Gary IN 46404-1506 Ph: (708) 359-2068 |
| NPI Number | 1396136511 |
|---|---|
| Provider Enumeration Date | 02/10/2015 |
| Last Update Date | 02/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396136511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12011381 (Indiana) | Primary |
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