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1400 Hudson Street Elkhart IN 46516 | |
| (574) 522-0104 | |
| (574) 522-1902 |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1400 Hudson Street, Elkhart, Indiana |
| Authorized Official Name and Position | Diantha Hostetler (CLINICAL MANAGER) |
| Authorized Official Contact | 5745232136 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
608 Oakland Avenue Elkhart IN 46516 Ph: (574) 523-2105 | 1400 Hudson Street Elkhart IN 46516 Ph: (574) 522-0104 |
| NPI Number | 1659596336 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 04/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659596336 | NPI | - | NPPES |
| 100112150A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
Hewitt Dental Group Of Elkhart, Ltd. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 319 W Lusher Ave, Elkhart, IN 46517 Phone: 574-389-8300 | |
J E Steele Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 423 Waterfall Dr, Elkhart, IN 46516 Phone: 574-293-6342 Fax: 574-522-8578 | |
Springer Dental Care Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3702 E Mishawaka Rd, Elkhart, IN 46517 Phone: 574-875-6595 | |
Dunlap Dental Services, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3700 E Mishawaka Rd, Suite 1, Elkhart, IN 46517 Phone: 574-875-6595 | |
Douglas J Snyder Dds, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 427 Waterfall Dr, Elkhart, IN 46516 Phone: 574-293-9495 | |