| Brazil Dental Center, Llc | |
|
21 N Washington St Brazil IN 47834-2204 | |
| (812) 448-3639 | |
| Not Available |
| Full Name | Brazil Dental Center, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 21 N Washington St, Brazil, Indiana |
| Authorized Official Name and Position | Tyler Richey (OWNER) |
| Authorized Official Contact | 8124483639 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brazil Dental Center, Llc 21 N Washington St Brazil IN 47834-2204 Ph: (812) 448-3639 | Brazil Dental Center, Llc 21 N Washington St Brazil IN 47834-2204 Ph: (812) 448-3639 |
| NPI Number | 1528542370 |
|---|---|
| Provider Enumeration Date | 09/18/2018 |
| Last Update Date | 09/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528542370 | NPI | - | NPPES |
| 201229120B | Medicaid | IN | |
| 300004053 | Medicaid | IN | |
| 201234800A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Campbell Dental Associates Brazil Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1204 E National Ave, Brazil, IN 47834 Phone: 812-446-1211 | |
Dr Linda Colter Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 803 W National Ave, Brazil, IN 47834 Phone: 812-446-2275 Fax: 812-446-6038 |