| St. Vincent Evansville Mobile Dental Clinic | |
|
3900 Washington Ave Evansville IN 47714-0550 | |
| (812) 485-5804 | |
| (812) 485-5810 |
| Full Name | St. Vincent Evansville Mobile Dental Clinic |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3900 Washington Ave, Evansville, Indiana |
| Authorized Official Name and Position | Daniel Parod (INTERIM PRESIDENT) |
| Authorized Official Contact | 8124851502 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Vincent Evansville Mobile Dental Clinic 3900 Washington Ave Evansville IN 47714-0550 Ph: (812) 485-5804 | St. Vincent Evansville Mobile Dental Clinic 3900 Washington Ave Evansville IN 47714-0550 Ph: (812) 485-5804 |
| NPI Number | 1033135660 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 06/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033135660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 65000006A (Indiana) | Primary |
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