Organization
UNITED DENTAL CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH FRIED DDS (PRESIDENT)
(219) 933-4900
Entity
Organization
Contact information
Practice address
5254 HOHMAN AVE, HAMMOND, IN 46320-1722
(219) 933-4900
Mailing address
5254 HOHMAN AVE, HAMMOND, IN 46320-1722
(219) 933-4900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009174
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100147560B
—
IN
Enumeration date
11/08/2010
Last updated
11/08/2010
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