# HEARTLAND DENTAL CARE OF INDIANA, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 21st Century Oral Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346452448
- **Authorized official:** AMY KROEGER (INS COOD)
- **Authorized official phone:** (217) 540-5100

## Contact information

- **Practice address:** 2016 S ELIZABETH ST, KOKOMO, IN 46902
- **Practice address phone:** (765) 452-0028
- **Practice address fax:** (765) 452-0890
- **Mailing address:** 2016 S ELIZABETH ST, KOKOMO, IN 46902
- **Mailing address phone:** (765) 452-0028
- **Mailing address fax:** (765) 452-0890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 08/22/2020