| Edgewood Dental, Llp | |
|
3008 Franklin St Michigan City IN 46360-4636 | |
| (219) 872-2110 | |
| (219) 872-1082 |
| Full Name | Edgewood Dental, Llp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3008 Franklin St, Michigan City, Indiana |
| Authorized Official Name and Position | Valerie Haughtington (PARTNER/DENTIST) |
| Authorized Official Contact | 2198722110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgewood Dental, Llp 3008 Franklin St Michigan City IN 46360 Ph: (219) 872-2110 | Edgewood Dental, Llp 3008 Franklin St Michigan City IN 46360-4636 Ph: (219) 872-2110 |
| NPI Number | 1124542139 |
|---|---|
| Provider Enumeration Date | 08/01/2017 |
| Last Update Date | 08/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124542139 | NPI | - | NPPES |
| 1053411645 | Other | IN | PROVIDER NPI |
| 100376490B | Medicaid | IN | |
| 1245390236 | Other | IN | PROVIDER NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12009354 (* (Not Available)) | Primary |
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