Organization
PEDIATRIC DENTISTRY OF NORTHWEST INDIANA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY G. SCHECHNER D.D.S. (PRESIDENT)
(219) 462-8779
Entity
Organization
Contact information
Practice address
809 WALL ST, SUITE D, VALPARAISO, IN 46383-2570
(219) 462-8779
(219) 531-2440
Mailing address
809 WALL ST, SUITE D, VALPARAISO, IN 46383-2570
(219) 462-8779
(219) 531-2440
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100914
CHILDRENS SPECIAL HEALTH
IN
01
—
755187
UNITED CONCORDIA
IN
Enumeration date
01/18/2007
Last updated
08/22/2020
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