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Organization
BONTRAGER FAMILY DENTISTRY LLC
Active
Organization
BONTRAGER FAMILY DENTISTRY LLC
Active
Other names
Firefly Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KALYSSA MAE BONTRAGER DDS (OWNER DENTIST)
(260) 580-5246
Entity
Organization
Contact information
Practice address
612 S DETROIT ST, LAGRANGE, IN 46761-2314
(260) 463-2111
Mailing address
PO BOX 183, STROH, IN 46789-0183
(260) 580-5246
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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