Organization
HIGHLAND CREEK FAMILY DENTAL - SOUTH LLC
Active
Other names
HIghland Creek Family Dental - South
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA-ROCHA (CREDENTIALING LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
3209 BUILDER DR STE 130, LAFAYETTE, IN 47909-4054
(765) 204-1676
Mailing address
3209 BUILDER DR STE 130, LAFAYETTE, IN 47909-4054
(765) 204-1676
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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