Organization
NEW HAVEN DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA RUTHERFORD (OFFICE MANAGER)
(260) 432-8596
Entity
Organization
Contact information
Practice address
615 PROFESSIONAL PARK DR, NEW HAVEN, IN 46774-1850
(260) 493-2113
Mailing address
615 PROFESSIONAL PARK DR, NEW HAVEN, IN 46774-1850
(260) 493-2113
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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