Organization
WABASH VALLEY DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUZANNE LINDLEY (RECEPTIONIST)
(812) 232-2557
Entity
Organization
Contact information
Practice address
1518 S 3RD ST, TERRE HAUTE, IN 47802-1012
(812) 232-2557
(812) 234-1365
Mailing address
1518 S 3RD ST, TERRE HAUTE, IN 47802-1012
(812) 232-2557
(812) 234-1365
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200499690A
—
IN
01
—
524674
UNITED CONCORDIA
IN
Enumeration date
05/07/2007
Last updated
06/17/2008
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