Organization
ELKHART DENTAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE LUBARSKY (OFFICE MANAGER)
(574) 522-0156
Entity
Organization
Contact information
Practice address
125 S NAPPANEE ST, ELKHART, IN 46514-1967
(574) 522-0156
(574) 294-1407
Mailing address
125 S NAPPANEE ST, ELKHART, IN 46514-1967
(574) 522-0156
(574) 294-1407
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12009361
IN
332BC3200X
Customized Equipment (DME)
Primary
12009361
IN
Other
Enumeration date
11/09/2015
Last updated
01/11/2017
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