Organization
UNITED DENTAL CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH FRIED DDS (PRESIDENT)
(219) 659-4900
Entity
Organization
Contact information
Practice address
1332 119TH ST, WHITING, IN 46394-1631
(219) 659-4900
Mailing address
1332 119TH ST, WHITING, IN 46394-1631
(219) 659-4900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009174
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100147560A
—
IN
Enumeration date
11/08/2010
Last updated
11/08/2010
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