# CROSSROADS PEDIATRIC DENTISTRY PC

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

## Provider details

- **NPI number:** 1043319619
- **Authorized official:** DR. MICHAEL F BIGLER DDS (PRESIDENT)
- **Authorized official phone:** (574) 875-6531

## Contact information

- **Practice address:** 21781 OMEGA CT, GOSHEN, IN 46528-7809
- **Practice address phone:** (574) 875-6531
- **Practice address fax:** (574) 875-8256
- **Mailing address:** 21781 OMEGA CT, GOSHEN, IN 46528-7809
- **Mailing address phone:** (574) 875-6531
- **Mailing address fax:** (574) 875-8256

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12007759 | IN | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 02/07/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100065260 | — | IN |