5th Ave Dental Inc.

NPI 1396136511 - Dentist - 1223G0001X

NPI Details
NPI 1396136511
Enumeration Date 02/10/2015
Last Updated 02/10/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name AMIT AMIT
Position PRESIDENT
Phone (708) 359-2068
Fax
Practice Location
1619 W 5TH AVE
GARY IN, 46404-1506, US
Phone (708) 359-2068
Fax
Business Location
814 W CHICAGO AVE
EAST CHICAGO IN, 46312-3307, US
Phone
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Indiana
License Number 12011381
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According to our database, 5th Ave Dental Inc. NPI is 1396136511, taxonomy code is 1223G0001X and license number is 12011381, license state is located at Indiana. 5th Ave Dental Inc. physically located at 1619 W 5th Ave, Gary IN, 46404-1506. NPI Number 1033115704 has the healthcare provider type.

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1396136511 NPI number is provided on an as is basis without warranty of any kind. 1396136511 is maintained by the National Plan & Provider Enumeration System. The contents of 5th Ave Dental Inc. are for informational purposes only.