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Dr. Thomas Pedavoli, DDS
General Practice Dentistry in South Bend, Indiana
NPI 1134148349

Thomas Pedavoli is a General Practice Dentistry based in South Bend, IN and is specialized in General Practice. Thomas Pedavoli practices in South Bend, IN and has the professional credentials of DDS. The NPI Number for Thomas Pedavoli is 1134148349 and holds a License No. 12008862 (Indiana).

The current practice location address for Thomas Pedavoli is 1005 E Lasalle Ave, South Bend, IN and can be reached out via phone at 574-245-7503 and via fax at 574-245-7502.

Location: 1005 E Lasalle Ave, South Bend, IN, 46617-2818
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134148349
Provider Name
Thomas Pedavoli
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1005 E Lasalle Ave, South Bend, IN, 46617-2818
Phone Number
574-245-7503
Fax Number
574-245-7502
Provider Enumeration Date
07/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
12008862 01 IN INDIANA LISCENSE
institution
Provider Business Practice Location Address Details
Address
1005 E Lasalle Ave
City
South Bend
State
Indiana
Zip
46617-2818
Phone Number
574-245-7503
Fax Number
574-245-7502
person
Provider Business Mailing Address Details
Address
1005 E Lasalle Ave
City
South Bend
State
Indiana
Zip
46617-2818
Phone Number
574-245-7503
Fax Number
574-245-7502
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
12008862 (Indiana)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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