Organization
JASPER FAMILY DENTISTRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS DRAKE (OFFICE MANAGER)
(812) 482-6610
Entity
Organization
Contact information
Practice address
715 MACARTHUR ST, JASPER, IN 47546-2621
(812) 482-6610
(812) 634-6610
Mailing address
715 MACARTHUR ST, JASPER, IN 47546-2621
(812) 482-6610
(812) 634-6610
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011481A
IN
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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