# LIMA ROAD DENTISTRY

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1710548326
- **Authorized official:** OPAL ANDERSON (COO)
- **Authorized official phone:** (260) 489-4090

## Contact information

- **Practice address:** 9019 LIMA RD, FORT WAYNE, IN 46818-1801
- **Practice address phone:** (260) 489-4090
- **Mailing address:** 9019 LIMA RD, FORT WAYNE, IN 46818-1801
- **Mailing address phone:** (260) 489-4090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/25/2019
- **Last updated:** 07/20/2022