# R M & M R STETZEL DDS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stetzel Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356463327
- **Authorized official:** DR. MARK R STETZEL D.D.S. (OWNER,PRESIDENT)
- **Authorized official phone:** (260) 490-9949

## Contact information

- **Practice address:** 10010 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1626
- **Practice address phone:** (260) 490-9949
- **Practice address fax:** (260) 490-3199
- **Mailing address:** 10010 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1626
- **Mailing address phone:** (260) 490-9949
- **Mailing address fax:** (260) 490-3199

## Taxonomy

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

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 06/30/2008