| Orange Door Dental Group Of Elkhart | |
|
110 N Nappanee St Elkhart IN 46514-1956 | |
| (574) 293-5216 | |
| (574) 522-1239 |
| Full Name | Orange Door Dental Group Of Elkhart |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 110 N Nappanee St, Elkhart, Indiana |
| Authorized Official Name and Position | Christiaan Anthony Willig (PRESIDENT) |
| Authorized Official Contact | 5742935216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orange Door Dental Group Of Elkhart 110 N Nappanee St Elkhart IN 46514-1956 Ph: (574) 293-5216 | Orange Door Dental Group Of Elkhart 110 N Nappanee St Elkhart IN 46514-1956 Ph: (574) 293-5216 |
| NPI Number | 1427370097 |
|---|---|
| Provider Enumeration Date | 02/23/2010 |
| Last Update Date | 12/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427370097 | NPI | - | NPPES |
| 200853580A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | IN12010401A (Indiana) | Primary |
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