Organization
HEALTHY SMILES NWI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS BERNARD CAIN D.D.S (CEO)
(615) 260-3544
Entity
Organization
Contact information
Practice address
4629 MELTON RD., GARY, IN 46403
(219) 938-2637
(219) 938-6338
Mailing address
4629 MELTON RD., GARY, IN 46403
(219) 938-2637
(219) 938-6338
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011235A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200992160
—
IN
Enumeration date
04/04/2012
Last updated
01/29/2013
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