| Adoni Dental Pc | |
|
4170 Grape Rd Mishawaka IN 46545-2610 | |
| (574) 272-4200 | |
| Not Available |
| Full Name | Adoni Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4170 Grape Rd, Mishawaka, Indiana |
| Authorized Official Name and Position | Samuel Wakim (OWNER) |
| Authorized Official Contact | 5742724200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adoni Dental Pc Po Box 3189 Syracuse NY 13220-3189 Ph: (315) 454-6000 | Adoni Dental Pc 4170 Grape Rd Mishawaka IN 46545-2610 Ph: (574) 272-4200 |
| NPI Number | 1356586382 |
|---|---|
| Provider Enumeration Date | 12/04/2008 |
| Last Update Date | 12/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356586382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12011100A (Indiana) | Primary |
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