Organization
MYINTY FRESH DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE BARBER (PROVIDER ENROLLMENT MANAGER)
(315) 454-6000
Entity
Organization
Contact information
Practice address
2377 E MAIN ST STE 175, PLAINFIELD, IN 46168-0015
(317) 837-8700
Mailing address
PO BOX 70887, CLEVELAND, OH 44190-0887
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/10/2026
Last updated
07/10/2026
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