# CRYSTAL VALLEY FAMILY DENTISTRY, P.C.

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

## Provider details

- **NPI number:** 1952310039
- **Authorized official:** DR. DAVID P REGAN DDS (PRESIDENT)
- **Authorized official phone:** (574) 825-4040

## Contact information

- **Practice address:** 1004 SPRING ARBOR DR, MIDDLEBURY, IN 46540-9493
- **Practice address phone:** (574) 825-4040
- **Practice address fax:** (574) 825-3377
- **Mailing address:** 1004 SPRING ARBOR DR, MIDDLEBURY, IN 46540-9493
- **Mailing address phone:** (574) 825-4040
- **Mailing address fax:** (574) 825-3377

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010372A | IN | Yes |

## Other

- **Enumeration date:** 08/06/2006
- **Last updated:** 08/22/2020