| Aegis Dental Group Fort Wayne, Llc | |
|
4975 W Jefferson Blvd Fort Wayne IN 46804 | |
| (574) 875-7711 | |
| Not Available |
| Full Name | Aegis Dental Group Fort Wayne, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4975 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Cynthia Neuenschwander (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5748757711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aegis Dental Group Fort Wayne, Llc 4975 W Jefferson Blvd Fort Wayne IN 46804 Ph: (574) 875-7711 | Aegis Dental Group Fort Wayne, Llc 4975 W Jefferson Blvd Fort Wayne IN 46804 Ph: (574) 875-7711 |
| NPI Number | 1992506513 |
|---|---|
| Provider Enumeration Date | 03/20/2025 |
| Last Update Date | 03/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992506513 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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