# DENTAL PROFESSIONALS OF IN, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL PROFESSIONALS OF IN, P.C.
- **Other names:** Innovative Dental Care of Muncie
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1538774419
- **Legal business name:** DENTAL PROFESSIONALS OF IN, P.C.
- **Authorized official:** TABATHA LEMKE (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 540-6078

## Contact information

- **Practice address:** 3701 N EVERETT RD, MUNCIE, IN 47304-5610
- **Practice address phone:** (765) 288-2040
- **Mailing address:** 3701 N EVERETT RD, MUNCIE, IN 47304-5610

## Taxonomy

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

## Other

- **Enumeration date:** 09/09/2020
- **Last updated:** 09/09/2020