Organization
HEALTHY SMILES PORTAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS CAIN (OWNER)
(219) 938-2637
Entity
Organization
Contact information
Practice address
6280 W MAIN ST, PORTAGE, IN 46368-4670
(219) 938-2637
Mailing address
4629 MELTON RD, GARY, IN 46403-2866
(219) 938-2637
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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