Organization
SALEM FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRICIA K WHEELER DMD (SOLE MEMBER)
(812) 883-5804
Entity
Organization
Contact information
Practice address
100 N HARRISON ST, SALEM, IN 47167-1426
(812) 883-5804
(812) 883-0603
Mailing address
2126 N STATE ROAD 135, SALEM, IN 47167-6005
(821) 620-1633
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12010386
IN
Other
Enumeration date
10/11/2017
Last updated
10/11/2017
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