Organization
EON CLINICS INDIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJAN SHARMA DDS, MSD (PRESIDENT)
(219) 924-5022
Entity
Organization
Contact information
Practice address
10020 CALUMET AVE, MUNSTER, IN 46321-4055
(219) 924-5022
Mailing address
10020 CALUMET AVE, MUNSTER, IN 46321-4055
(219) 924-5022
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
021001569
IL
1223P0700X
Prosthodontics
021001569
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021001569
IL
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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