# WABASH VALLEY DENTAL GROUP

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

## Provider details

- **NPI number:** 1487866711
- **Authorized official:** MRS. SUZANNE LINDLEY (RECEPTIONIST)
- **Authorized official phone:** (812) 232-2557

## Contact information

- **Practice address:** 1518 S 3RD ST, TERRE HAUTE, IN 47802-1012
- **Practice address phone:** (812) 232-2557
- **Practice address fax:** (812) 234-1365
- **Mailing address:** 1518 S 3RD ST, TERRE HAUTE, IN 47802-1012
- **Mailing address phone:** (812) 232-2557
- **Mailing address fax:** (812) 234-1365

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/07/2007
- **Last updated:** 06/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200499690A | — | IN |
| 01 | — | 524674 | UNITED CONCORDIA | IN |