Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
FONTAINE DENTAL GROUP
Active
Organization
FONTAINE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JOY FONTAINE (DDS)
(219) 365-7773
Entity
Organization
Contact information
Practice address
9301 WICKER AVE, SAINT JOHN, IN 46373-9403
(219) 365-7773
(219) 365-8883
Mailing address
9301 WICKER AVE, SAINT JOHN, IN 46373-9403
(219) 365-7773
(219) 365-8883
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010668
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12010668
LICENSE
IN
Enumeration date
07/17/2009
Last updated
07/17/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers