# CARMIEN & PEDAVOLI FAMILY DENTISTRY, LLC

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

## Provider details

- **NPI number:** 1780446989
- **Authorized official:** DR. MATTHEW CARMIEN DDS (OWNER/PARTNER DENTIST)
- **Authorized official phone:** (574) 963-2527

## Contact information

- **Practice address:** 850 COLUMBUS DR, PLYMOUTH, IN 46563-1877
- **Practice address phone:** (574) 963-2527
- **Mailing address:** 850 COLUMBUS DR, PLYMOUTH, IN 46563-1877
- **Mailing address phone:** (574) 963-2527

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/24/2024
- **Last updated:** 01/24/2024