Organization
CAYLOR NICKEL CLINIC, PC
Active
Organization
CAYLOR NICKEL CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY S BUMGARNER (DIRECTOR HUMAN RESOURCES)
(260) 919-3302
Entity
Organization
Contact information
Practice address
1 CAYLOR NICKEL SQ, BLUFFTON, IN 46714-2529
(260) 919-3302
(260) 919-3551
Mailing address
1 CAYLOR NICKEL SQ, BLUFFTON, IN 46714-2529
(260) 919-3302
(260) 919-3551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100449040A
—
IN
05
—
200383890
—
IN
Enumeration date
05/17/2006
Last updated
10/21/2011
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