# ALLUSION DENTAL, INC

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

## Provider details

- **NPI number:** 1215275284
- **Authorized official:** DR. STEPHANIE D JOLY DDS (PRESIDENT)
- **Authorized official phone:** (219) 762-4266

## Contact information

- **Practice address:** 2646 LOIS ST, PORTAGE, IN 46368-3500
- **Practice address phone:** (219) 762-4266
- **Mailing address:** 2646 LOIS ST, PORTAGE, IN 46368-3500
- **Mailing address phone:** (219) 762-4266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12011254A | IN | Yes |

## Other

- **Enumeration date:** 01/24/2013
- **Last updated:** 01/24/2013