Organization
FREMONT FAMILY DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN H. MAUK D.D.S (PRESIDENT)
(260) 495-2255
Entity
Organization
Contact information
Practice address
1003 W TOLEDO STREET, FREMONT, IN 46737-0667
(260) 495-2255
(260) 495-9023
Mailing address
P.O. BOX 667, FREMONT, IN 46737-0667
(260) 495-2255
(260) 495-9023
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012537445 001 7
IN
Other
Enumeration date
05/03/2007
Last updated
05/17/2016
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