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Organization

OMNI DENTAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TESSA C CREAGER DDS (PRESIDENT/OWNER)
(260) 203-4920
Entity
Organization

Contact information

Practice address
10020 DUPONT CIRCLE CT, STE 150, FORT WAYNE, IN 46825-1620
(260) 203-4920
(260) 203-4923
Mailing address
10020 DUPONT CIRCLE CT, STE 150, FORT WAYNE, IN 46825-1620
(260) 203-4920
(260) 203-4923

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011483A
IN

Other

Enumeration date
07/26/2016
Last updated
12/13/2016
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