# HEWITT DENTAL GROUP OF GOSHEN, LTD.

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

## Provider details

- **NPI number:** 1700114261
- **Authorized official:** DR. SCOTT HEWITT DDS (PRESIDENT)
- **Authorized official phone:** (574) 532-3085

## Contact information

- **Practice address:** 211 E MADISON ST, GOSHEN, IN 46526-3427
- **Practice address phone:** (574) 534-8777
- **Mailing address:** PO BOX 806, MIDDLEBURY, IN 46540-0806
- **Mailing address phone:** (574) 229-8180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12007801A | IN | Yes |

## Other

- **Enumeration date:** 11/20/2009
- **Last updated:** 11/20/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100222340 | — | IN |