Christiana Creek Dental Care
Clinic/Center in Elkhart, IN. Organization (NPI-2).
NPI number1528195286
StatusActive
Last updated in NPPESFeb 6, 2012
Details
- NPI
- 1528195286
- Entity type
- Organization (NPI-2)
- Legal business name
- Christiana Creek Dental Care
- Organization subpart
- No
- Enumeration date
- Feb 28, 2007
- Last updated
- Feb 6, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 12011190A | IN | Yes |
Practice location
301 W Bristol StElkhart, IN 46514-3078
Phone 574-262-4378 · Fax 574-266-1481
Mailing address
301 W Bristol StElkhart, IN 46514-3078
Phone 574-262-4378 · Fax 574-266-1481
Authorized official
Gavin A Schill
President
5742624378
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