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Pediatric Dentistry Of Northwest Indiana Pc
Pediatric Dentist in Highland, Indiana
NPI 1861417818

Pediatric Dentistry Of Northwest Indiana Pc is a Pediatric Dentist based in Highland, IN and is specialized in Pediatric Dentistry. Pediatric Dentistry Of Northwest Indiana Pc practices in Highland, IN. The NPI Number for Pediatric Dentistry Of Northwest Indiana Pc is 1861417818 and holds a License No. 12008141A (Indiana).

The current practice location address for Pediatric Dentistry Of Northwest Indiana Pc is 2833 Lincoln St, Highland, IN and can be reached out via phone at 219-838-2007 and via fax at 219-972-5267.

Location: 2833 Lincoln St, Highland, IN, 46322-1924
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1861417818
Provider Name
Pediatric Dentistry Of Northwest Indiana Pc
Credential
Provider Entity Type
Organization
Address
2833 Lincoln St, Highland, IN, 46322-1924
Phone Number
219-838-2007
Fax Number
219-972-5267
Provider Enumeration Date
07/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
130765 01 IN UNITED CONCORDIA
155777 01 IN CHILDRENS SPECIAL HEALTH
institution
Provider Business Practice Location Address Details
Address
2833 Lincoln St
City
Highland
State
Indiana
Zip
46322-1924
Phone Number
219-838-2007
Fax Number
219-972-5267
person
Provider Business Mailing Address Details
Address
2833 Lincoln St
City
Highland
State
Indiana
Zip
46322-1924
Phone Number
219-838-2007
Fax Number
219-972-5267
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
12008141A (Indiana)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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