# BOONE AND COCQUYT LLC DBA ERSKINE FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Erskine Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356469746
- **Authorized official:** MRS. BRIDGET K CLARK (FINANCIAL MANAGER)
- **Authorized official phone:** (574) 299-9300

## Contact information

- **Practice address:** 734 E IRELAND RD, ERSKINE FAMILY DENTISTRY, SOUTH BEND, IN 46614-2662
- **Practice address phone:** (574) 299-9300
- **Practice address fax:** (574) 299-9853
- **Mailing address:** 734 E IRELAND RD, ERSKINE FAMILY DENTISTRY, SOUTH BEND, IN 46614-2662
- **Mailing address phone:** (574) 299-9300
- **Mailing address fax:** (574) 299-9853

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009004 | IN | — |
| 1223G0001X | General Practice Dentistry | 12009553 | IN | Yes |
| 1223G0001X | General Practice Dentistry | 12010048 | IN | — |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 08/22/2020