# FAMILY DENTAL CARE PC

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

## Provider details

- **NPI number:** 1952462657
- **Authorized official:** DR. CHANBO SIM DDS (PRESIDENT)
- **Authorized official phone:** (219) 980-0319

## Contact information

- **Practice address:** 6075 CLEVELAND CIRCLE, MERRILLVILLE, IN 46410
- **Practice address phone:** (219) 980-0319
- **Practice address fax:** (219) 980-0379
- **Mailing address:** 6075 CLEVELAND CIRCLE, MERRILLVILLE, IN 46410
- **Mailing address phone:** (219) 980-0319
- **Mailing address fax:** (219) 980-0379

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12009372A | IN | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 08/22/2020