| Fort Wayne Endodontics | |
|
9407 Illinois Rd Fort Wayne IN 46804 | |
| (260) 436-5772 | |
| (260) 436-5779 |
| Full Name | Fort Wayne Endodontics |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 9407 Illinois Rd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Jason P Glassley (PRESIDENT) |
| Authorized Official Contact | 2604365772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Wayne Endodontics 9407 Illinois Rd Fort Wayne IN 46804 Ph: (260) 436-5772 | Fort Wayne Endodontics 9407 Illinois Rd Fort Wayne IN 46804 Ph: (260) 436-5772 |
| NPI Number | 1083265433 |
|---|---|
| Provider Enumeration Date | 09/26/2019 |
| Last Update Date | 09/26/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083265433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
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