| L. Rhett Fagg, D.d.s., M.s.d., Pc | |
|
211 Medical Plz Michigan City IN 46360-3364 | |
| (219) 879-4559 | |
| (219) 879-4559 |
| Full Name | L. Rhett Fagg, D.d.s., M.s.d., Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 211 Medical Plz, Michigan City, Indiana |
| Authorized Official Name and Position | Cynthia A Bechinski (STAFF ASSISTANT) |
| Authorized Official Contact | 2198794559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| L. Rhett Fagg, D.d.s., M.s.d., Pc 211 Medical Plz Michigan City IN 46360-3364 Ph: (219) 879-4559 | L. Rhett Fagg, D.d.s., M.s.d., Pc 211 Medical Plz Michigan City IN 46360-3364 Ph: (219) 879-4559 |
| NPI Number | 1568635183 |
|---|---|
| Provider Enumeration Date | 04/03/2008 |
| Last Update Date | 09/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568635183 | NPI | - | NPPES |
| 200356670A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 12007148A (Indiana) | Primary |
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