# DENTAL CENTER OF GOSHEN PLLC

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

## Provider details

- **NPI number:** 1013285766
- **Authorized official:** MIKE COLE (INSURANCE DIRECTOR)
- **Authorized official phone:** (727) 726-1611

## Contact information

- **Practice address:** 4024 ELKHART RD, GOSHEN, IN 46526-5807
- **Practice address phone:** (574) 534-7577
- **Mailing address:** 4024 ELKHART RD, GOSHEN, IN 46526-5807

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 12/09/2011
- **Last updated:** 12/09/2011