| Highland Creek Family Dental | |
|
4921 State Road 26 E Suite 100 Lafayette IN 47905-4608 | |
| (765) 807-0592 | |
| (765) 269-7696 |
| Full Name | Highland Creek Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 4921 State Road 26 E, Lafayette, Indiana |
| Authorized Official Name and Position | Shane T Cope (OWNER) |
| Authorized Official Contact | 7658070592 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Highland Creek Family Dental 4921 State Road 26 East Suite 100 Lafayette IN 47905-4616 Ph: (765) 807-0592 | Highland Creek Family Dental 4921 State Road 26 E Suite 100 Lafayette IN 47905-4608 Ph: (765) 807-0592 |
| NPI Number | 1750724613 |
|---|---|
| Provider Enumeration Date | 04/10/2013 |
| Last Update Date | 05/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750724613 | NPI | - | NPPES |
| 200880660 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | 12011052A (Indiana) | Secondary |
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