# GOSHEN COSMETIC AND ADVANCED FAMILY DENTISTRY PC

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

## Provider details

- **NPI number:** 1356562631
- **Authorized official:** DR. CHAD G. STUTSMAN DDS (OWNER)
- **Authorized official phone:** (574) 533-8934

## Contact information

- **Practice address:** 1801 CHARLTON CT, GOSHEN, IN 46526-6464
- **Practice address phone:** (574) 533-8934
- **Practice address fax:** (574) 533-9487
- **Mailing address:** 1801 CHARLTON CT, GOSHEN, IN 46526-6464
- **Mailing address phone:** (574) 533-8934
- **Mailing address fax:** (574) 533-9487

## Taxonomy

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

## Other

- **Enumeration date:** 05/02/2007
- **Last updated:** 07/10/2017