Organization
ADONI DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL WAKIM DDS (OWNER)
(574) 272-4200
Entity
Organization
Contact information
Practice address
4170 GRAPE RD, MISHAWAKA, IN 46545-2610
(574) 272-4200
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011100A
IN
Other
Enumeration date
12/04/2008
Last updated
12/04/2008
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