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Organization

JEFFREY W RHONEMUS,D.D.S.,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY WILLIAM RHONEMUS DDS (PRES)
(765) 458-5618
Entity
Organization

Contact information

Practice address
302 S FAIRGROUND ST, LIBERTY, IN 47353-1414
(765) 458-5618
(765) 458-6734
Mailing address
302 S FAIRGROUND ST, LIBERTY, IN 47353-1414
(765) 458-5618
(765) 458-6734

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
54001205
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
54001205
INDIANA CORP LICENSE
IN
Enumeration date
09/13/2007
Last updated
09/13/2007
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