# LENA B FERMBACK DDS PC

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

## Provider details

- **NPI number:** 1134265846
- **Authorized official:** DR. LENA B FERMBACK DDS (PRESIDENT)
- **Authorized official phone:** (574) 267-3040

## Contact information

- **Practice address:** 1010 S UNION ST, WARSAW, IN 46580-4706
- **Practice address phone:** (716) 574-3040
- **Practice address fax:** (574) 268-2530
- **Mailing address:** 1010 S UNION ST, WARSAW, IN 46580-4706
- **Mailing address phone:** (716) 574-3040
- **Mailing address fax:** (574) 268-2530

## Taxonomy

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

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 08/22/2020