# COSMOPOLITAN DENTISTRY

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

## Provider details

- **NPI number:** 1750450052
- **Authorized official:** DR. LUIS L CUELLAR D.D.S. (PRESIDENT)
- **Authorized official phone:** (219) 548-2322

## Contact information

- **Practice address:** 225 ABERDEEN DR, SUITE E, VALPARAISO, IN 46385-7762
- **Practice address phone:** (219) 548-2322
- **Practice address fax:** (312) 577-0841
- **Mailing address:** 225 ABERDEEN DR, SUITE E, VALPARAISO, IN 46385-7762
- **Mailing address phone:** (219) 548-2322
- **Mailing address fax:** (312) 577-0841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12008232A | IN | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 08/22/2020