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Organization
ORA NW INDIANA, LLC
Active
Organization
ORA NW INDIANA, LLC
Active
Other names
Dental Image
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL MCGONIGLE (VP)
(708) 906-4236
Entity
Organization
Contact information
Practice address
10705 RANDOLPH ST, CROWN POINT, IN 46307-7615
(219) 779-9114
Mailing address
10705 RANDOLPH ST, CROWN POINT, IN 46307-7615
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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