| Smiles By Doctor D | |
|
1123 Joliet St Dyer IN 46311-1926 | |
| (219) 865-3303 | |
| (219) 865-3244 |
| Full Name | Smiles By Doctor D |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1123 Joliet St, Dyer, Indiana |
| Authorized Official Name and Position | Marti Benne (OFFICE MANANGER) |
| Authorized Official Contact | 2198653303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles By Doctor D 1123 Joliet St Dyer IN 46311-1926 Ph: (219) 865-3303 | Smiles By Doctor D 1123 Joliet St Dyer IN 46311-1926 Ph: (219) 865-3303 |
| NPI Number | 1306227129 |
|---|---|
| Provider Enumeration Date | 06/17/2015 |
| Last Update Date | 06/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306227129 | NPI | - | NPPES |
| 100168120A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12007851A (Indiana) | Primary |
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