| Indiana University Health La Porte Hospital Inc | |
|
400 Teegarden La Porte IN 46350-3175 | |
| (219) 326-2403 | |
| (219) 326-2385 |
| Full Name | Indiana University Health La Porte Hospital Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 400 Teegarden, La Porte, Indiana |
| Authorized Official Name and Position | G Thor Thordarson (PRESIDENT/CEO) |
| Authorized Official Contact | 2193262555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indiana University Health La Porte Hospital Inc 400 Teegarden La Porte IN 46350-3175 Ph: (219) 326-2403 | Indiana University Health La Porte Hospital Inc 400 Teegarden La Porte IN 46350-3175 Ph: (219) 326-2403 |
| NPI Number | 1992884878 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 09/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992884878 | NPI | - | NPPES |
| 200237780A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 06-005006-1 (Indiana) | Secondary |
| 261QD0000X | Clinic/center - Dental | 11-005006-1 (Indiana) | Primary |
Wolf Family Dentistry, Pc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3550 W Johnson Rd, La Porte, IN 46350 Phone: 219-362-3730 Fax: 219-324-4273 | |
James M. Vanes D.d.s. Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1025 Indiana Ave, La Porte, IN 46350 Phone: 219-362-2529 Fax: 219-362-2189 | |
Ronald Corley, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 614 Andrew Ave, La Porte, IN 46350 Phone: 219-326-7530 Fax: 219-326-7531 | |
Innovo Management, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 N. Madison St, La Porte, IN 46350 Phone: 219-380-0029 | |
Bunmi Adekugbe Dmd Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Michigan Ave, La Porte, IN 46350 Phone: 219-369-6882 | |
Maple City Dentistry, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Michigan Ave, La Porte, IN 46350 Phone: 219-362-1101 |