Creating Smiles Pc | |
8217 Wicker Ave St John IN 46373 | |
(219) 322-9920 | |
(219) 322-2039 |
Full Name | Creating Smiles Pc |
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Speciality | Dentist - General Practice |
Location | 8217 Wicker Ave, St John, Indiana |
Authorized Official Name and Position | Scott A Kapers (DDS) |
Authorized Official Contact | 2193229920 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Creating Smiles Pc 8217 Wicker Ave St John IN 46373 Ph: (219) 322-9920 | Creating Smiles Pc 8217 Wicker Ave St John IN 46373 Ph: (219) 322-9920 |
NPI Number | 1528483021 |
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Provider Enumeration Date | 02/20/2014 |
Last Update Date | 02/20/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528483021 | NPI | - | NPPES |
100148080 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 12009570 (Indiana) | Primary |
1223G0001X | Dentist - General Practice | 12011967A (Indiana) | Secondary |