Organization
MARSHALL COUNTY FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL M MCLEOD DDS (PRESIDENT)
(574) 532-0011
Entity
Organization
Contact information
Practice address
125 S STEWART ST, BREMEN, IN 46506-1829
(574) 645-3037
Mailing address
125 S STEWART ST, BREMEN, IN 46506-1829
(574) 645-3037
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
200091260A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790909000
—
IN
Enumeration date
05/27/2014
Last updated
05/27/2014
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