# DENTAL 360 DYER LLC

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

## Provider details

- **NPI number:** 1316713290
- **Authorized official:** IVANA BUENO (DIRECTOR)
- **Authorized official phone:** (773) 798-9382

## Contact information

- **Practice address:** 890 RICHARD RD, DYER, IN 46311-1779
- **Practice address phone:** (219) 322-1326
- **Mailing address:** 890 RICHARD RD, DYER, IN 46311-1779

## Taxonomy

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

## Other

- **Enumeration date:** 11/30/2023
- **Last updated:** 11/30/2023