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Individual

DR. BERNARD JAY ASDELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
707 N MICHIGAN ST, STE 300, SOUTH BEND, IN 46601-1070
(574) 289-0080
(574) 287-6320
Mailing address
707 N MICHIGAN ST, SUITE 300, SOUTH BEND, IN 46601
(574) 289-0080
(574) 287-6320

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12008287
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100090950
IN
Enumeration date
06/10/2005
Last updated
04/18/2012
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