Organization
HEWITT DENTAL GROUP OF ELKHART, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT HEWITT DDS (PRESIDENT)
(574) 532-3085
Entity
Organization
Contact information
Practice address
319 W LUSHER AVE, ELKHART, IN 46517-1866
(574) 389-8300
Mailing address
PO BOX 806, MIDDLEBURY, IN 46540-0806
(574) 229-8180
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007801A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100222340
—
IN
Enumeration date
11/11/2009
Last updated
11/11/2009
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