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Organization

PERIODONTIC SPECIALISTS, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LEAH GABREK (OPERATING SECRETARY)
(260) 432-0577
Entity
Organization

Contact information

Practice address
7750 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4174
(260) 432-0577
(206) 432-0578
Mailing address
7750 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4174
(260) 432-0577
(206) 432-0578

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary

Other

Enumeration date
06/12/2008
Last updated
06/12/2008
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