Organization
MARK PEFLEY
Active
Other names
familydentalcare
Organization subpart
No
Provider details
NPI number
Authorized official
BETH A PARKER (OFFICE MANAGER)
(765) 642-3588
Entity
Organization
Contact information
Practice address
1736 BROADWAY ST, ANDERSON, IN 46012-2447
(765) 642-3588
(765) 649-1226
Mailing address
1736 BROADWAY ST, ANDERSON, IN 46012-2447
(765) 642-3588
(765) 649-1226
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10017297OA
—
IN
Enumeration date
04/01/2019
Last updated
04/01/2019
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