# THE VILLAGE DENTIST, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Village Dentist
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053360479
- **Authorized official:** DR. TERRY H VIBBERT D.D.S. (PRESIDENT)
- **Authorized official phone:** (812) 424-3368

## Contact information

- **Practice address:** 903 NORTH PARK DRIVE, EVANSVILLE, IN 47710-3629
- **Practice address phone:** (812) 424-3368
- **Practice address fax:** (801) 881-7780
- **Mailing address:** PO BOX 9054, EVANSVILLE, IN 47724-7054
- **Mailing address phone:** (812) 424-3368
- **Mailing address fax:** (801) 881-7780

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12009155 | IN | Yes |
| 122300000X | Dentist | 12010628 | IN | — |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 08/22/2020