Organization
KENTLAND FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELINDA SUE BODINE DDS (ASSOCIATE)
(219) 474-5059
Entity
Organization
Contact information
Practice address
310 E LINCOLN ST, KENTLAND, IN 47951-1135
(219) 474-5059
Mailing address
310 E LINCOLN ST, KENTLAND, IN 47951-1135
(219) 474-5059
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1639581507
IN
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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