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777 Broadway Suite B Anderson IN 46012 | |
| (765) 642-3124 | |
| (765) 642-1095 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 777 Broadway, Anderson, Indiana |
| Authorized Official Name and Position | Jennifer Hoelscher (INSURANCE/CREDENTIALING) |
| Authorized Official Contact | 2175405100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
777 Broadway Suite B Anderson IN 46012 Ph: (765) 642-3124 | 777 Broadway Suite B Anderson IN 46012 Ph: (765) 642-3124 |
| NPI Number | 1497977946 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 02/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497977946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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