# DEANA FUGATE DMD PC

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

## Provider details

- **NPI number:** 1710638358
- **Authorized official:** DEANA FUGATE DMD (OWNER/DENTIST)
- **Authorized official phone:** (865) 208-5147

## Contact information

- **Practice address:** 1213 W LINCOLN AVE, GOSHEN, IN 46526-2130
- **Practice address phone:** (574) 533-6911
- **Mailing address:** 55623 LITTLE CREEK LN, MIDDLEBURY, IN 46540-8677
- **Mailing address phone:** (865) 208-5147

## Taxonomy

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

## Other

- **Enumeration date:** 01/14/2022
- **Last updated:** 06/15/2022