Sodabeh Etminan DMD

NPI 1003047929 - Dentist - 1223G0001X

NPI Details
NPI 1003047929
Gender Female
Enumeration Date 07/28/2009
Last Updated 04/16/2015
Entity Type Individual
Active Over 7 years ago
Practice Location
6920 INDIANAPOLIS BOULEVARD
HAMMOND IN, 46324-1105, US
Phone (219) 763-8112
Fax (219) 764-3251
Business Location
PO BOX 1430
PORTAGE IN, 46368-9230, US
Phone (219) 763-8112
Fax (219) 764-3251
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 019.027979
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According to our database, Dr. Sodabeh Etminan DMD NPI is 1003047929, taxonomy code is 1223G0001X and license number is 019.027979, license state is located at Illinois. Sodabeh Etminan DMD physically located at 6920 Indianapolis Boulevard, Hammond IN, 46324-1105. NPI Number Sodabeh Etminan DMD has the Individual type.

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1003047929 NPI number is provided on an as is basis without warranty of any kind. 1003047929 is maintained by the National Plan & Provider Enumeration System. The contents of Sodabeh Etminan DMD are for informational purposes only.