| The Muncie Dental Place L.l.c. | |
|
1804 W Mcgalliard Rd Muncie IN 47304-2209 | |
| (765) 282-5655 | |
| (765) 587-0103 |
| Full Name | The Muncie Dental Place L.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1804 W Mcgalliard Rd, Muncie, Indiana |
| Authorized Official Name and Position | Teresa Michelle Watkins (OWNER) |
| Authorized Official Contact | 7652825655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Muncie Dental Place L.l.c. 1804 W Mcgalliard Rd Muncie IN 47304-2209 Ph: (765) 282-5655 | The Muncie Dental Place L.l.c. 1804 W Mcgalliard Rd Muncie IN 47304-2209 Ph: (765) 282-5655 |
| NPI Number | 1508133638 |
|---|---|
| Provider Enumeration Date | 11/17/2011 |
| Last Update Date | 11/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508133638 | NPI | - | NPPES |
| 200888510 | Medicaid | IN | |
| 200962440 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12010271A (Indiana) | Primary |
| 1223G0001X | Dentist - General Practice | 12011056A (Indiana) | Secondary |
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Affordable Dentures - Muncie, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5081 W Hessler Rd, Muncie, IN 47304 Phone: 765-286-8090 | |
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