| C Chase Ellinwood Dds Llc | |
|
5725 Maplecrest Rd Ste 1 Fort Wayne IN 46835-4937 | |
| (260) 492-2640 | |
| Not Available |
| Full Name | C Chase Ellinwood Dds Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5725 Maplecrest Rd Ste 1, Fort Wayne, Indiana |
| Authorized Official Name and Position | Charles Chase Elilnwood (MEMBER) |
| Authorized Official Contact | 2604922640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C Chase Ellinwood Dds Llc 5725 Maplecrest Rd Ste 1 Fort Wayne IN 46835-4937 Ph: () - | C Chase Ellinwood Dds Llc 5725 Maplecrest Rd Ste 1 Fort Wayne IN 46835-4937 Ph: (260) 492-2640 |
| NPI Number | 1316753916 |
|---|---|
| Provider Enumeration Date | 12/09/2024 |
| Last Update Date | 12/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316753916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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