| Omni Dental Pc | |
|
10020 Dupont Circle Ct Ste 150 Fort Wayne IN 46825-1620 | |
| (260) 203-4920 | |
| (260) 203-4923 |
| Full Name | Omni Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 10020 Dupont Circle Ct, Fort Wayne, Indiana |
| Authorized Official Name and Position | Tessa C Creager (PRESIDENT/OWNER) |
| Authorized Official Contact | 2602034920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Dental Pc 10020 Dupont Circle Ct Ste 150 Fort Wayne IN 46825-1620 Ph: (260) 203-4920 | Omni Dental Pc 10020 Dupont Circle Ct Ste 150 Fort Wayne IN 46825-1620 Ph: (260) 203-4920 |
| NPI Number | 1437602521 |
|---|---|
| Provider Enumeration Date | 07/26/2016 |
| Last Update Date | 12/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437602521 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12011483A (Indiana) | Primary |
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