Lakeshore Family Dental, P.c.

NPI 1053411645 - Dentist - 1223G0001X

NPI Details
NPI 1053411645
Enumeration Date 09/23/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name VIDAS THOMAS VIDAS
Position PRESIDENT
Phone (219) 872-2116
Fax (219) 874-7087
Practice Location
1232 E MICHIGAN BLVD
MICHIGAN CITY IN, 46360-4856, US
Phone (219) 872-2116
Fax (219) 874-7087
Business Location
1232 E MICHIGAN BLVD
MICHIGAN CITY IN, 46360-4856, US
Phone (219) 872-2116
Fax (219) 874-7087
Toxanomy
Taxonomy Code 1223G0001X
License State Indiana
License Number 54001178A
Remove 1053411645 NPI Number
 

According to our database, Lakeshore Family Dental, P.c. NPI is 1053411645, taxonomy code is 1223G0001X and license number is 54001178A, license state is located at Indiana. Lakeshore Family Dental, P.c. physically located at 1232 E Michigan Blvd, Michigan City IN, 46360-4856. NPI Number 1033115704 has the healthcare provider type.

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1053411645 NPI number is provided on an as is basis without warranty of any kind. 1053411645 is maintained by the National Plan & Provider Enumeration System. The contents of Lakeshore Family Dental, P.c. are for informational purposes only.