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Crossroads Pediatric Dentistry Pc
Dental Clinic/Center in Goshen, Indiana
NPI 1043319619

Crossroads Pediatric Dentistry Pc is a Dental Clinic/Center based in Goshen, IN and is specialized in Dental. Crossroads Pediatric Dentistry Pc practices in Goshen, IN. The NPI Number for Crossroads Pediatric Dentistry Pc is 1043319619 and holds a License No. 12007759 (Indiana).

The current practice location address for Crossroads Pediatric Dentistry Pc is 21781 Omega Ct, Goshen, IN and can be reached out via phone at 574-875-6531 and via fax at 574-875-8256.

Location: 21781 Omega Ct, Goshen, IN, 46528-7809
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1043319619
Provider Name
Crossroads Pediatric Dentistry Pc
Credential
Provider Entity Type
Organization
Address
21781 Omega Ct, Goshen, IN, 46528-7809
Phone Number
574-875-6531
Fax Number
574-875-8256
Provider Enumeration Date
09/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100065260 05 IN
institution
Provider Business Practice Location Address Details
Address
21781 Omega Ct
City
Goshen
State
Indiana
Zip
46528-7809
Phone Number
574-875-6531
Fax Number
574-875-8256
person
Provider Business Mailing Address Details
Address
21781 Omega Ct
City
Goshen
State
Indiana
Zip
46528-7809
Phone Number
574-875-6531
Fax Number
574-875-8256
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
12007759 (Indiana)
Definition
Definition to come...
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