Llyndall Rhett Fagg DDS MSD

NPI 1093715963 - Dentist - 1223P0221X

NPI Details
NPI 1093715963
Gender Male
Enumeration Date 07/21/2005
Last Updated 09/12/2012
Entity Type Individual
Active Over 11 years ago
Practice Location
211 MEDICAL PLZ
MICHIGAN CITY IN, 46360-3364, US
Phone (219) 879-4559
Fax (219) 879-4559
Business Location
211 MEDICAL PLZ
MICHIGAN CITY IN, 46360-3364, US
Phone (219) 879-4559
Fax (219) 879-4559
Toxanomy
Taxonomy Code 1223P0221X
License State Indiana
License Number 12007148A
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According to our database, Dr. Llyndall Rhett Fagg DDS MSD NPI is 1093715963, taxonomy code is 1223P0221X and license number is 12007148A, license state is located at Indiana. Llyndall Rhett Fagg DDS MSD physically located at 211 Medical Plz, Michigan City IN, 46360-3364. NPI Number Llyndall Rhett Fagg DDS MSD has the Individual type.

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1093715963 NPI number is provided on an as is basis without warranty of any kind. 1093715963 is maintained by the National Plan & Provider Enumeration System. The contents of Llyndall Rhett Fagg DDS MSD are for informational purposes only.