Individual
DR. BAO Q DINH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6035 STERLING CREEK RD, PORTAGE, IN 46368-7752
(219) 850-1218
Mailing address
2740 40TH ST APT 2B, HIGHLAND, IN 46322-2768
(219) 805-8606
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012926A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105715582099
—
IN
Enumeration date
05/25/2018
Last updated
05/25/2018
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