| Hewitt Dental Group Of Elkhart, Ltd. | |
|
319 W Lusher Ave Elkhart IN 46517-1866 | |
| (574) 389-8300 | |
| Not Available |
| Full Name | Hewitt Dental Group Of Elkhart, Ltd. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 319 W Lusher Ave, Elkhart, Indiana |
| Authorized Official Name and Position | Scott Hewitt (PRESIDENT) |
| Authorized Official Contact | 5745323085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hewitt Dental Group Of Elkhart, Ltd. Po Box 806 Middlebury IN 46540-0806 Ph: (574) 229-8180 | Hewitt Dental Group Of Elkhart, Ltd. 319 W Lusher Ave Elkhart IN 46517-1866 Ph: (574) 389-8300 |
| NPI Number | 1053648055 |
|---|---|
| Provider Enumeration Date | 11/11/2009 |
| Last Update Date | 11/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053648055 | NPI | - | NPPES |
| 100222340 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12007801A (Indiana) | Primary |
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