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Organization

LIFETIME DENTAL CARE OF INDIANA, PC

Active
Parent organization
LIFETIME DENTAL CARE OF INDIANA, PC
Other names
Dental Design of Fort Wayne
Organization subpart
Yes

Provider details

NPI number
Legal business name
LIFETIME DENTAL CARE OF INDIANA, PC
Authorized official
JENNIFER HOELSCHER (INS COOD)
(217) 540-5100
Entity
Organization

Contact information

Practice address
2828 E STATE BLVD, FORT WAYNE, IN 46805-4761
(260) 482-6689
(260) 482-6948
Mailing address
2828 E STATE BLVD, FORT WAYNE, IN 46805-4761
(260) 482-6689
(260) 482-6948

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
05/03/2007
Last updated
11/01/2014
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