# JEFFREY W RHONEMUS,D.D.S.,P.C.

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

## Provider details

- **NPI number:** 1124213962
- **Authorized official:** DR. JEFFREY WILLIAM RHONEMUS DDS (PRES)
- **Authorized official phone:** (765) 458-5618

## Contact information

- **Practice address:** 302 S FAIRGROUND ST, LIBERTY, IN 47353-1414
- **Practice address phone:** (765) 458-5618
- **Practice address fax:** (765) 458-6734
- **Mailing address:** 302 S FAIRGROUND ST, LIBERTY, IN 47353-1414
- **Mailing address phone:** (765) 458-5618
- **Mailing address fax:** (765) 458-6734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 54001205 | IN | Yes |

## Other

- **Enumeration date:** 09/13/2007
- **Last updated:** 09/13/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 54001205 | INDIANA CORP LICENSE | IN |