| Prime Dental Care Llc | |
|
435 W Coliseum Blvd Fort Wayne IN 46805-1010 | |
| (260) 263-6200 | |
| Not Available |
| Full Name | Prime Dental Care Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 435 W Coliseum Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Vijay Kumar Godi (DENTIST) |
| Authorized Official Contact | 4197885803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Dental Care Llc 3210 Troutwood Dr Fort Wayne IN 46818-8791 Ph: (419) 788-5803 | Prime Dental Care Llc 435 W Coliseum Blvd Fort Wayne IN 46805-1010 Ph: (260) 263-6200 |
| NPI Number | 1053199539 |
|---|---|
| Provider Enumeration Date | 09/18/2023 |
| Last Update Date | 09/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053199539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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