Individual
DR. JAY CHRISTOPHER PLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
322 INDIANAPOLIS BOULEVARD, SUITE 100, SCHERERVILLE, IN 46375-2656
(219) 864-1133
(219) 864-9203
Mailing address
322 INDIANAPOLIS BOULEVARD, SUITE 100, SCHERERVILLE, IN 46375-2656
(219) 864-1133
(219) 864-9203
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12008814A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084416
BC BS PROVIDER PIN NUMBER
IN
01
—
000000084417
BC BS PROVIDER PIN NUMBER
IN
01
—
761022
UNITED CONCORDIA NUMBER
IN
Enumeration date
11/10/2005
Last updated
07/09/2007
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