# HEALTHY SMILES NWI

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003172008
- **Authorized official:** DR. NICHOLAS BERNARD CAIN D.D.S (CEO)
- **Authorized official phone:** (615) 260-3544

## Contact information

- **Practice address:** 4629 MELTON RD., GARY, IN 46403
- **Practice address phone:** (219) 938-2637
- **Practice address fax:** (219) 938-6338
- **Mailing address:** 4629 MELTON RD., GARY, IN 46403
- **Mailing address phone:** (219) 938-2637
- **Mailing address fax:** (219) 938-6338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12011235A | IN | Yes |

## Other

- **Enumeration date:** 04/04/2012
- **Last updated:** 01/29/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200992160 | — | IN |