| Family Dental Care Pc | |
|
6075 Cleveland Circle Merrillville IN 46410 | |
| (219) 980-0319 | |
| (219) 980-0379 |
| Full Name | Family Dental Care Pc |
|---|---|
| Speciality | Dentist |
| Location | 6075 Cleveland Circle, Merrillville, Indiana |
| Authorized Official Name and Position | Chanbo Sim (PRESIDENT) |
| Authorized Official Contact | 2199800319 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Care Pc 6075 Cleveland Circle Merrillville IN 46410 Ph: (219) 980-0319 | Family Dental Care Pc 6075 Cleveland Circle Merrillville IN 46410 Ph: (219) 980-0319 |
| NPI Number | 1952462657 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8921379413 |
|---|---|
| Medicare Enrollment ID | O20170801003826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952462657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12009372A (Indiana) | Primary |
| Provider Name | Chanbo Sim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1760543466 PECOS PAC ID: 5890098701 Enrollment ID: I20170821002326 |
Dr. Daniel J. Femiak D.d.s., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8687 Connecticut Street Ste. E., Merrillville, IN 46410 Phone: 219-793-9710 Fax: 219-793-9549 | |
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