Fairmount Family Dentist | |
215 E Washington St Fairmount IN 46928-1747 | |
(765) 948-4107 | |
Not Available |
Full Name | Fairmount Family Dentist |
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Speciality | Clinic/center - Dental |
Location | 215 E Washington St, Fairmount, Indiana |
Authorized Official Name and Position | David J Shock (OWNER) |
Authorized Official Contact | 7659484107 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Fairmount Family Dentist 215 E Washington St Fairmount IN 46928-1747 Ph: (765) 948-4107 | Fairmount Family Dentist 215 E Washington St Fairmount IN 46928-1747 Ph: (765) 948-4107 |
NPI Number | 1518412139 |
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Provider Enumeration Date | 08/24/2016 |
Last Update Date | 08/24/2016 |
Identifier | Type | State | Issuer |
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1518412139 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 12011164A (Indiana) | Primary |