| Amazing Dental | |
|
5200 Washington Ave Suite E Evansville IN 47715-4863 | |
| (812) 488-2008 | |
| (812) 475-9831 |
| Full Name | Amazing Dental |
|---|---|
| Speciality | Dentist |
| Location | 5200 Washington Ave, Evansville, Indiana |
| Authorized Official Name and Position | Ruthie M Jimerson (PRESIDENT) |
| Authorized Official Contact | 8124882008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amazing Dental 5200 Washington Ave Suite E Evansville IN 47715-4863 Ph: (812) 488-2008 | Amazing Dental 5200 Washington Ave Suite E Evansville IN 47715-4863 Ph: (812) 488-2008 |
| NPI Number | 1174841126 |
|---|---|
| Provider Enumeration Date | 05/13/2010 |
| Last Update Date | 05/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174841126 | NPI | - | NPPES |
| PENDING | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12011105A (Indiana) | Primary |
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