SOUTH BEND CHILDRENS DENTISTRY PC NPI 1366579005

NPI Information

SOUTH BEND CHILDRENS DENTISTRY PC is a pediatric dentistry dentist in South Bend, IN. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. SOUTH BEND CHILDRENS DENTISTRY PC NPI is 1366579005. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

103 S EDDY
SOUTH BEND, IN
ZIP 46617
Phone: (574) 288-4400

The provider's authorized official is Deanna O'neil .
The authorized official title is President South Bend Childrens Dent and has the following contact phone number (574) 288-4400.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 1/31/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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