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Organization
HILLCREST FAMILY DENTAL CENTER , P.C.
Active
Organization
HILLCREST FAMILY DENTAL CENTER , P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND GORDON KLOCKOW D.D.S. (PRESIDENT)
(219) 866-7117
Entity
Organization
Contact information
Practice address
331 E AMSLER RD, RENSSELAER, IN 47978-8591
(219) 866-7117
(219) 866-8658
Mailing address
331 E AMSLER RD, RENSSELAER, IN 47978-8591
(219) 866-7117
(219) 866-8658
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5400-1122
IN
Other
Enumeration date
05/03/2006
Last updated
08/22/2020
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