Organization
LAGRANGE FAMILY DENTISTRY LLC
Active
Parent organization
BONTRAGER FAMILY DENTISTRY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BONTRAGER FAMILY DENTISTRY LLC
Authorized official
DR. KALYSSA BONTRAGER (OWNER/ DOCTOR)
(260) 463-2111
Entity
Organization
Contact information
Practice address
612 S DETROIT ST, LAGRANGE, IN 46761-2314
(260) 463-2111
Mailing address
612 S DETROIT ST, LAGRANGE, IN 46761-2314
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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