# KENTLAND FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1366854143
- **Authorized official:** DR. MELINDA SUE BODINE DDS (ASSOCIATE)
- **Authorized official phone:** (219) 474-5059

## Contact information

- **Practice address:** 310 E LINCOLN ST, KENTLAND, IN 47951-1135
- **Practice address phone:** (219) 474-5059
- **Mailing address:** 310 E LINCOLN ST, KENTLAND, IN 47951-1135
- **Mailing address phone:** (219) 474-5059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 1639581507 | IN | Yes |

## Other

- **Enumeration date:** 05/28/2014
- **Last updated:** 05/28/2014