Individual
VRUTI PRAVIN SICINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
910 I ST, LA PORTE, IN 46350-5533
(219) 325-0202
Mailing address
1120 MOSSY LN, MISHAWAKA, IN 46544-9054
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013409A
IN
Other
Enumeration date
07/15/2020
Last updated
04/03/2026
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