Organization
CAVANAUGH ORTHODONTICS PC
Active
Organization
CAVANAUGH ORTHODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT K CAVANAUGH DDS (ORTHODONTIST)
(219) 476-4110
Entity
Organization
Contact information
Practice address
800 WALL STREET, SUITE A, VALPARAISO, IN 46383-2564
(219) 476-4110
(219) 476-9042
Mailing address
800 WALL STREET, SUITE A, VALPARAISO, IN 46383-2564
(219) 476-4110
(219) 476-9042
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
12005966A
IN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12010044A
IN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
12010862A
IN
Other
Enumeration date
05/22/2007
Last updated
08/24/2010
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