Michigan City Pediatric Dentistry | |
211 E. 4th Street Michigan City IN 46360-3364 | |
(219) 879-4559 | |
(219) 879-4559 |
Full Name | Michigan City Pediatric Dentistry |
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Speciality | Dentist - Pediatric Dentistry |
Location | 211 E. 4th Street, Michigan City, Indiana |
Authorized Official Name and Position | Lisa M Leniski (OWNER/PRESIDENT) |
Authorized Official Contact | 2198794559 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Michigan City Pediatric Dentistry 211 Medical Plz Michigan City IN 46360-3364 Ph: (219) 879-4559 | Michigan City Pediatric Dentistry 211 E. 4th Street Michigan City IN 46360-3364 Ph: (219) 879-4559 |
NPI Number | 1376945634 |
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Provider Enumeration Date | 09/18/2014 |
Last Update Date | 07/06/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376945634 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 12010935A (Indiana) | Primary |
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