Organization
JANSEN FAMILY DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN JANSEN (BUSINESS MANAGER)
(260) 347-5115
Entity
Organization
Contact information
Practice address
230 S MAIN STREET, KENDALLVILLE, IN 46755-1718
(260) 347-5115
(260) 347-9098
Mailing address
230 S MAIN STREET, KENDALLVILLE, IN 46755-1718
(260) 347-5115
(260) 347-9098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100190860A
—
IN
05
—
200389980A
—
IN
Enumeration date
05/10/2006
Last updated
07/22/2024
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