Immediadent | |
713 Us Highway 41 Ste A Schererville IN 46375-1798 | |
(219) 293-8039 | |
(866) 591-0604 |
Full Name | Immediadent |
---|---|
Speciality | Dentist |
Location | 713 Us Highway 41 Ste A, Schererville, Indiana |
Authorized Official Name and Position | Monica L Long (MANAGER OF PROVIDER CREDENTIALING) |
Authorized Official Contact | 9134281686 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Immediadent Po Box 11568 Overland Park KS 66207-4268 Ph: (913) 428-1686 | Immediadent 713 Us Highway 41 Ste A Schererville IN 46375-1798 Ph: (219) 293-8039 |
NPI Number | 1760913958 |
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Provider Enumeration Date | 03/21/2017 |
Last Update Date | 05/01/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760913958 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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