| Bontrager Family Dentistry Llc | |
|
612 S Detroit St Lagrange IN 46761-2314 | |
| (260) 463-2111 | |
| Not Available |
| Full Name | Bontrager Family Dentistry Llc |
|---|---|
| Speciality | Dentist |
| Location | 612 S Detroit St, Lagrange, Indiana |
| Authorized Official Name and Position | Kalyssa Mae Bontrager (OWNER DENTIST) |
| Authorized Official Contact | 2605805246 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bontrager Family Dentistry Llc Po Box 183 Stroh IN 46789-0183 Ph: (260) 580-5246 | Bontrager Family Dentistry Llc 612 S Detroit St Lagrange IN 46761-2314 Ph: (260) 463-2111 |
| NPI Number | 1366001679 |
|---|---|
| Provider Enumeration Date | 06/10/2019 |
| Last Update Date | 06/10/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366001679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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