| Crossroads Pediatric Dentistry Pc | |
|
21781 Omega Ct Goshen IN 46528-7809 | |
| (574) 875-6531 | |
| (574) 875-8256 |
| Full Name | Crossroads Pediatric Dentistry Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 21781 Omega Ct, Goshen, Indiana |
| Authorized Official Name and Position | Michael F Bigler (PRESIDENT) |
| Authorized Official Contact | 5748756531 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Pediatric Dentistry Pc 21781 Omega Ct Goshen IN 46528-7809 Ph: (574) 875-6531 | Crossroads Pediatric Dentistry Pc 21781 Omega Ct Goshen IN 46528-7809 Ph: (574) 875-6531 |
| NPI Number | 1043319619 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 02/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043319619 | NPI | - | NPPES |
| 100065260 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 12007759 (Indiana) | Primary |
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