Organization
DECATUR DENTAL SERVICES, INC.
Active
Parent organization
DECATUR DENTAL SERVICES, INC.
Other names
Bluffton Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
DECATUR DENTAL SERVICES, INC.
Authorized official
PAMELA JOHNSON (DENTIST)
(260) 824-5940
Entity
Organization
Contact information
Practice address
1417 BAKER PL, BLUFFTON, IN 46714-1180
(260) 824-5940
Mailing address
1417 BAKER PL, BLUFFTON, IN 46714-1180
(260) 824-5940
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010359
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200379120A
—
IN
Enumeration date
06/12/2008
Last updated
04/10/2025
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