# DECATUR DENTAL SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DECATUR DENTAL SERVICES, INC.
- **Other names:** Bluffton Dental Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1144480179
- **Legal business name:** DECATUR DENTAL SERVICES, INC.
- **Authorized official:** PAMELA JOHNSON (DENTIST)
- **Authorized official phone:** (260) 824-5940

## Contact information

- **Practice address:** 1417 BAKER PL, BLUFFTON, IN 46714-1180
- **Practice address phone:** (260) 824-5940
- **Mailing address:** 1417 BAKER PL, BLUFFTON, IN 46714-1180
- **Mailing address phone:** (260) 824-5940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010359 | IN | Yes |

## Other

- **Enumeration date:** 06/12/2008
- **Last updated:** 04/10/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200379120A | — | IN |