# ADONI DENTAL PC

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

## Provider details

- **NPI number:** 1356586382
- **Authorized official:** DR. SAMUEL WAKIM DDS (OWNER)
- **Authorized official phone:** (574) 272-4200

## Contact information

- **Practice address:** 4170 GRAPE RD, MISHAWAKA, IN 46545-2610
- **Practice address phone:** (574) 272-4200
- **Mailing address:** PO BOX 3189, SYRACUSE, NY 13220-3189
- **Mailing address phone:** (315) 454-6000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12011100A | IN | Yes |

## Other

- **Enumeration date:** 12/04/2008
- **Last updated:** 12/04/2008