# DENNIS L CHURCH DDS INC

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

## Provider details

- **NPI number:** 1790849313
- **Authorized official:** DR. DENNIS L CHURCH DDS (PRESIDENT)
- **Authorized official phone:** (765) 552-0211

## Contact information

- **Practice address:** 213 NORTH 16TH ST, ELWOOD, IN 46036
- **Practice address phone:** (765) 552-0211
- **Practice address fax:** (765) 552-5106
- **Mailing address:** 213 NORTH 16TH ST, ELWOOD, IN 46036
- **Mailing address phone:** (765) 552-0211
- **Mailing address fax:** (765) 552-5106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12007767A | IN | Yes |

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 08/22/2020