| Dean Family Dental Practice, Llc | |
|
710 W Mill Rd Evansville IN 47710-3928 | |
| (812) 425-4251 | |
| (812) 425-3086 |
| Full Name | Dean Family Dental Practice, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 710 W Mill Rd, Evansville, Indiana |
| Authorized Official Name and Position | Dianne E. Dean (MEMBER, LLC / OFFICE MANAGER) |
| Authorized Official Contact | 8124254251 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dean Family Dental Practice, Llc 710 W Mill Rd Evansville IN 47710-3928 Ph: (812) 425-4251 | Dean Family Dental Practice, Llc 710 W Mill Rd Evansville IN 47710-3928 Ph: (812) 425-4251 |
| NPI Number | 1629415419 |
|---|---|
| Provider Enumeration Date | 06/03/2013 |
| Last Update Date | 06/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629415419 | NPI | - | NPPES |
| 100241450A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12006932A (Indiana) | Primary |
| 1223G0001X | Dentist - General Practice | 12011866A (Indiana) | Secondary |
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