# THE PORTLAND DENTAL PLACE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1982972790
- **Authorized official:** DR. TERESA M WATKINS DDS (DENTIST)
- **Authorized official phone:** (260) 726-4710

## Contact information

- **Practice address:** 112 N SHIP ST, PORTLAND, IN 47371-1844
- **Practice address phone:** (260) 726-4710
- **Practice address fax:** (260) 726-7051
- **Mailing address:** 112 N SHIP ST, PORTLAND, IN 47371-1844
- **Mailing address phone:** (260) 726-4710
- **Mailing address fax:** (260) 726-7051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010271A | IN | Yes |

## Other

- **Enumeration date:** 12/07/2011
- **Last updated:** 12/07/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200888510 | — | IN |
| 05 | — | 200962440 | — | IN |