# R. JASON SCHNEPF DDS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broad Smile Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457573669
- **Authorized official:** DR. R JASON SCHNEPF DDS (DENTIST)
- **Authorized official phone:** (219) 922-7870

## Contact information

- **Practice address:** 423 N BROAD ST, GRIFFITH, IN 46319-2223
- **Practice address phone:** (219) 922-7870
- **Practice address fax:** (219) 922-8056
- **Mailing address:** 423 N BROAD ST, GRIFFITH, IN 46319-2223
- **Mailing address phone:** (219) 922-7870
- **Mailing address fax:** (219) 922-8056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010464A | IN | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 09/25/2007