institution
Jefferson Dental Center, Inc.
Dental Clinic/Center in South Bend, Indiana
NPI 1760762108

Jefferson Dental Center, Inc. is a Dental Clinic/Center based in South Bend, IN and is specialized in Dental. Jefferson Dental Center, Inc. practices in South Bend, IN. The NPI Number for Jefferson Dental Center, Inc. is 1760762108 and holds a License No. 12009908 A (Indiana).

The current practice location address for Jefferson Dental Center, Inc. is 2628 E Jefferson Blvd, South Bend, IN and can be reached out via phone at 574-233-7266 and via fax at 574-233-7560.

Location: 2628 E Jefferson Blvd, South Bend, IN, 46615-2724
institution
Provider Profile Details
NPI Number
1760762108
Provider Name
Jefferson Dental Center, Inc.
Credential
Provider Entity Type
Organization
Address
2628 E Jefferson Blvd, South Bend, IN, 46615-2724
Phone Number
574-233-7266
Fax Number
574-233-7560
Provider Enumeration Date
08/17/2011
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100222700A 05 IN
200496100A 05 IN
institution
Provider Business Practice Location Address Details
Address
2628 E Jefferson Blvd
City
State
Zip
46615-2724
Phone Number
574-233-7266
Fax Number
574-233-7560
person
Provider Business Mailing Address Details
Address
2628 E Jefferson Blvd
City
State
Zip
46615-2724
Phone Number
574-233-7266
Fax Number
574-233-7560
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
12009908 A (Indiana)
Definition
Definition to come...
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