Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 103 Osceola Ave, Osceola, Indiana |
Authorized Official Name and Position | Jennifer Hoelscher (INSURANCE/CREDENTIALING) |
Authorized Official Contact | 2175405100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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103 Osceola Ave Osceola IN 46561 Ph: (574) 674-8757 | 103 Osceola Ave Osceola IN 46561 Ph: (574) 674-8757 |
NPI Number | 1881816007 |
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Provider Enumeration Date | 05/03/2007 |
Last Update Date | 02/05/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881816007 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |