Individual
THEODORE L DEAL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
225 FAIRVIEW BLVD, KENDALLVILLE, IN 46755
(260) 347-2251
(260) 347-2261
Mailing address
225 FAIRVIEW BLVD, KENDALLVILLE, IN 46755
(260) 347-2251
(260) 347-2261
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009443A
IN
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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