| Childrens Dental Specialist | |
|
803 W Gardner Dr Marion IN 46952-1819 | |
| (765) 664-0587 | |
| Not Available |
| Full Name | Childrens Dental Specialist |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 803 W Gardner Dr, Marion, Indiana |
| Authorized Official Name and Position | Alice M. Butterworth (OWNER) |
| Authorized Official Contact | 7656640587 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Dental Specialist 803 W Gardner Dr Marion IN 46952-1819 Ph: (765) 664-0587 | Childrens Dental Specialist 803 W Gardner Dr Marion IN 46952-1819 Ph: (765) 664-0587 |
| NPI Number | 1598273393 |
|---|---|
| Provider Enumeration Date | 01/15/2018 |
| Last Update Date | 01/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598273393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 12007455A (Indiana) | Primary |
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