Organization
ALLUSION DENTAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE D JOLY DDS (PRESIDENT)
(219) 762-4266
Entity
Organization
Contact information
Practice address
2646 LOIS ST, PORTAGE, IN 46368-3500
(219) 762-4266
Mailing address
2646 LOIS ST, PORTAGE, IN 46368-3500
(219) 762-4266
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011254A
IN
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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