Organization
ROOT CANAL SPECIALTY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TODD MABRY (PRESIDENT)
(260) 436-9439
Entity
Organization
Contact information
Practice address
4636 W JEFFERSON BLVD, FORT WAYNE, IN 46804
(260) 436-9439
(260) 436-9467
Mailing address
4636 W JEFFERSON BLVD, FORT WAYNE, IN 46804
(260) 436-9439
(260) 436-9467
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
8592
IN
Other
Enumeration date
08/24/2006
Last updated
08/22/2020
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