PERIODONTAL ASSOCIATES OF SOUTH BEND NPI 1962078642

NPI Information

PERIODONTAL ASSOCIATES OF SOUTH BEND is a periodontics dentist in South Bend, IN. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PERIODONTAL ASSOCIATES OF SOUTH BEND NPI is 1962078642. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1918 EDISON RD
SOUTH BEND, IN
ZIP 46617-711
Phone: (574) 287-8900

The provider's authorized official is Gloria Royer .
The authorized official title is Practice Manager and has the following contact phone number (765) 447-9319.

The enumeration date for this NPI number is 6/2/2021 and was last updated on 6/2/2021.

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:

Other Identifiers

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