Organization
MAPLE FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDY DIANN MAPLE DDS (OWNER)
(574) 753-4717
Entity
Organization
Contact information
Practice address
718 E BROADWAY, LOGANSPORT, IN 46947-3158
(574) 753-4717
(574) 732-1076
Mailing address
718 E BROADWAY, LOGANSPORT, IN 46947-3158
(574) 753-4717
(574) 732-1076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010584A
IN
Other
Enumeration date
02/14/2007
Last updated
07/25/2007
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