Individual
BRENDA KAY HARVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1308
Mailing address
VA DENTAL CLINIC, FORT WAYNE, IN 46805
(260) 426-5431
(260) 460-1308
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
159827
IN
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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