# CHALLGREN DENTISTRY PC

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

## Provider details

- **NPI number:** 1649676354
- **Authorized official:** ERIK CHALLGREN DDS (PRESIDENT)
- **Authorized official phone:** (765) 446-9606

## Contact information

- **Practice address:** 170 PROFESSIONAL CT, LAFAYETTE, IN 47905-5153
- **Practice address phone:** (765) 446-9606
- **Practice address fax:** (765) 446-9699
- **Mailing address:** 170 PROFESSIONAL CT, LAFAYETTE, IN 47905-5153
- **Mailing address phone:** (765) 446-9606
- **Mailing address fax:** (765) 446-9699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 54001793A | IN | Yes |

## Other

- **Enumeration date:** 11/06/2014
- **Last updated:** 11/06/2014