| The Portland Dental Place | |
|
112 N Ship St Portland IN 47371-1844 | |
| (260) 726-4710 | |
| (260) 726-7051 |
| Full Name | The Portland Dental Place |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 112 N Ship St, Portland, Indiana |
| Authorized Official Name and Position | Teresa M Watkins (DENTIST) |
| Authorized Official Contact | 2607264710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Portland Dental Place 112 N Ship St Portland IN 47371-1844 Ph: (260) 726-4710 | The Portland Dental Place 112 N Ship St Portland IN 47371-1844 Ph: (260) 726-4710 |
| NPI Number | 1982972790 |
|---|---|
| Provider Enumeration Date | 12/07/2011 |
| Last Update Date | 12/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982972790 | NPI | - | NPPES |
| 200888510 | Medicaid | IN | |
| 200962440 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12010271A (Indiana) | Primary |
John Cascio, D.d.s., Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 W North St, Portland, IN 47371 Phone: 260-726-7006 | |
Malcolm C. George, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 N Ship St, Portland, IN 47371 Phone: 260-726-4710 Fax: 260-726-7051 | |
C. H. Miller, D.d.s. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 N Ship St, Portland, IN 47371 Phone: 260-726-4710 | |
Thomas M. Banta, D.d.s., Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1413 W Votaw St, Portland, IN 47371 Phone: 260-726-7822 | |
Dunn Family Dental Care Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 W North St, Portland, IN 47371 Phone: 260-726-8007 Fax: 260-726-2505 | |
Vormohr Family Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1413 W Votaw St, Portland, IN 47371 Phone: 260-726-7822 |