GEORGETOWN NORTH DENTAL CARE LLC NPI 1255849667

NPI Information

GEORGETOWN NORTH DENTAL CARE LLC is a dental clinic center in Fort Wayne, IN. GEORGETOWN NORTH DENTAL CARE LLC NPI is 1255849667. The provider is registered as an organization entity type.
The provider Is Doing Business As Georgetown North Dental Group.

The provider's business location address is:

6405 GEORGETOWN NORTH BLVD
FORT WAYNE, IN
ZIP 46815-007
Phone: (260) 485-0583

The provider's authorized official is Opal Anderson .
The authorized official title is Regional Operations Manager and has the following contact phone number (260) 485-0583.

The CLIA number assigned to this NPI record is 15D2132192 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/19/2018 and was last updated on 7/20/2022.

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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