| Cedar Lake Dental Center, Inc. | |
|
13955 Morse St Cedar Lake IN 46303-9639 | |
| (219) 374-5591 | |
| (219) 662-2573 |
| Full Name | Cedar Lake Dental Center, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13955 Morse St, Cedar Lake, Indiana |
| Authorized Official Name and Position | Richard Douglas Kazwell (PRESIDENT) |
| Authorized Official Contact | 2193745591 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Lake Dental Center, Inc. 13955 Morse St Cedar Lake IN 46303-9639 Ph: (219) 374-5591 | Cedar Lake Dental Center, Inc. 13955 Morse St Cedar Lake IN 46303-9639 Ph: (219) 374-5591 |
| NPI Number | 1326126871 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326126871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54000250A (Indiana) | Primary |
Detailed Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13963 Morse St, Cedar Lake, IN 46303 Phone: 219-374-2400 | |
Moody Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13955 Morse St, Cedar Lake, IN 46303 Phone: 219-374-5591 Fax: 219-374-5592 |