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Periodontal Associates Of South Bend
Periodontist in South Bend, Indiana
NPI 1962078642

Periodontal Associates Of South Bend is a Periodontist based in South Bend, IN and is specialized in Periodontics. Periodontal Associates Of South Bend practices in South Bend, IN. The NPI Number for Periodontal Associates Of South Bend is 1962078642 and holds a License No. (Indiana).

The current practice location address for Periodontal Associates Of South Bend is 1918 Edison Rd, South Bend, IN and can be reached out via phone at 574-287-8900.

Location: 1918 Edison Rd, South Bend, IN, 46617-1711
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1962078642
Provider Name
Periodontal Associates Of South Bend
Credential
Provider Entity Type
Organization
Address
1918 Edison Rd, South Bend, IN, 46617-1711
Phone Number
574-287-8900
Fax Number
Provider Enumeration Date
06/02/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
12013130A 01 IN DENTAL LICENSE
institution
Provider Business Practice Location Address Details
Address
1918 Edison Rd
City
South Bend
State
Indiana
Zip
46617-1711
Phone Number
574-287-8900
Fax Number
person
Provider Business Mailing Address Details
Address
1918 Edison Rd
City
South Bend
State
Indiana
Zip
46617-1711
Phone Number
574-287-8900
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Periodontics
Taxonomy
1223P0300X
License No.
()
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
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