Individual
AMANDA LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2090 E COMMERCIAL AVE, LOWELL, IN 46356-2116
(219) 696-0250
Mailing address
7003 W 205TH AVE, LOWELL, IN 46356-9767
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12014761A
IN
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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