Lfd Orthodontics LLC
Dentist, Orthodontics and Dentofacial Orthopedics in Lagrange, IN. Organization (NPI-2).
NPI number1891551917
StatusActive
Last updated in NPPESFeb 26, 2024
Details
- NPI
- 1891551917
- Entity type
- Organization (NPI-2)
- Legal business name
- Lfd Orthodontics LLC
- Organization subpart
- No
- Enumeration date
- Feb 26, 2024
- Certification date
- Feb 26, 2024
- Last updated
- Feb 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – | Yes |
Practice location
612 S Detroit StLagrange, IN 46761-2314
Phone 260-463-2111
Mailing address
612 S Detroit StLagrange, IN 46761-2314
Phone 260-463-2111
Authorized official
Kalyssa Bontrager
Owner
2604632111
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