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195 Deanna Dr. Lowell IN 46341-2402 | |
(219) 696-1181 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 195 Deanna Dr., Lowell, Indiana |
Authorized Official Name and Position | David William Conaway (PRESIDENT) |
Authorized Official Contact | 2196961181 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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195 Deanna Dr. Lowell IN 46341-2402 Ph: (219) 696-1181 | 195 Deanna Dr. Lowell IN 46341-2402 Ph: (219) 696-1181 |
NPI Number | 1104175702 |
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Provider Enumeration Date | 08/29/2012 |
Last Update Date | 08/29/2012 |
Identifier | Type | State | Issuer |
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1104175702 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 12010857A (Indiana) | Primary |