Organization
DENTAL PROFESSIONALS OF INDIANA, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF INDIANA, P.C.
Other names
Brennan Dental Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF INDIANA, P.C.
Authorized official
CASSANDRA TEUTSCH (CREDENTIALING COORDINATOR)
(217) 540-8972
Entity
Organization
Contact information
Practice address
330 PARK PL, MISHAWAKA, IN 46545-3555
(574) 259-9956
Mailing address
330 PARK PL, MISHAWAKA, IN 46545-3555
(574) 259-9956
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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