| Elkhart Dental Center Pc | |
|
125 S Nappanee St Elkhart IN 46514-1967 | |
| (574) 522-0156 | |
| (574) 294-1407 |
| Full Name | Elkhart Dental Center Pc |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies - Customized Equipment |
| Location | 125 S Nappanee St, Elkhart, Indiana |
| Authorized Official Name and Position | Sue Lubarsky (OFFICE MANAGER) |
| Authorized Official Contact | 5745220156 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elkhart Dental Center Pc 125 S Nappanee St Elkhart IN 46514-1967 Ph: (574) 522-0156 | Elkhart Dental Center Pc 125 S Nappanee St Elkhart IN 46514-1967 Ph: (574) 522-0156 |
| NPI Number | 1962875286 |
|---|---|
| Provider Enumeration Date | 11/09/2015 |
| Last Update Date | 01/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962875286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12009361 (Indiana) | Secondary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 12009361 (Indiana) | Primary |
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