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Organization
PURDUE UNIVERSITY
Active
Organization
PURDUE UNIVERSITY
Active
Parent organization
PURDUE UNIVERSITY
Other names
IPFW Dental Hygiene Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PURDUE UNIVERSITY
Authorized official
MS. JOAN M VAUGHAN (DIRECTOR HIPAA PRIVACY COMPLIANCE)
(765) 496-1927
Entity
Organization
Contact information
Practice address
2101 EAST COLISEUM BOULEVARD, NEFF HALL ROOM 109, FORT WAYNE, IN 46805-1499
(260) 481-6575
(260) 481-4162
Mailing address
601 STADIUM MALL DRIVE, WEST LAFAYETTE, IN 47907-2052
(765) 496-1927
(765) 496-1227
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/29/2007
Last updated
08/02/2022
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