Individual
DR. JEFF VANDEVENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3105 MIDDLE ROAD, SUITE A, COLUMBUS, IN 47203-4472
(812) 379-4321
(812) 379-1977
Mailing address
3105 MIDDLE ROAD, SUITE A, COLUMBUS, IN 47203-4472
(812) 379-4321
(812) 379-1977
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11814
TN
1223G0001X
General Practice Dentistry
Primary
12009154
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200450770-A
—
IN
Enumeration date
10/13/2006
Last updated
06/27/2023
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