# DOGWOOD DENTAL LLC

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

## Provider details

- **NPI number:** 1407479058
- **Authorized official:** DR. NICKOLAUS M WEISS DDS (DENTIST)
- **Authorized official phone:** (812) 279-9767

## Contact information

- **Practice address:** 262 N MAPLE ST, ORLEANS, IN 47452-1426
- **Practice address phone:** (812) 279-9767
- **Practice address fax:** (812) 279-5971
- **Mailing address:** 1545 J ST, BEDFORD, IN 47421-3839
- **Mailing address phone:** (812) 279-9767
- **Mailing address fax:** (812) 279-5971

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 05/18/2020
- **Last updated:** 05/18/2020