| University Park Family Dentistry, Llc | |
|
16597 State Road 23 South Bend IN 46635-1461 | |
| (574) 272-4441 | |
| (574) 968-0689 |
| Full Name | University Park Family Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 16597 State Road 23, South Bend, Indiana |
| Authorized Official Name and Position | Jeffrey Allen Turner (OWNER) |
| Authorized Official Contact | 5742724441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Park Family Dentistry, Llc 16597 State Road 23 South Bend IN 46635-1461 Ph: (574) 272-4441 | University Park Family Dentistry, Llc 16597 State Road 23 South Bend IN 46635-1461 Ph: (574) 272-4441 |
| NPI Number | 1508248360 |
|---|---|
| Provider Enumeration Date | 06/29/2015 |
| Last Update Date | 06/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508248360 | NPI | - | NPPES |
| 200261730 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 120092272 (Indiana) | Primary |
Michiana Oral &maxillofacial Surgery Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 707 N Michigan St, Suite 300, South Bend, IN 46601 Phone: 574-289-0080 Fax: 574-287-6320 | |
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