Organization
JR STEWART D.D.S. ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH R STEWART D.D.S. (DR.)
(219) 733-2929
Entity
Organization
Contact information
Practice address
108 SOUTH ILLINOIS STREET, WANATAH, IN 46390-0359
(219) 733-2929
(219) 733-1329
Mailing address
PO BOX 359, 108 SOUTH ILLINOIS STREET, WANATAH, IN 46390-0359
(219) 733-2929
(219) 733-1329
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
8658
IN
Other
Enumeration date
10/05/2013
Last updated
10/05/2013
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