| Creating Smiles Pc | |
|
8217 Wicker Ave St John IN 46373 | |
| (219) 322-9920 | |
| (219) 322-2039 |
| Full Name | Creating Smiles Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8217 Wicker Ave, St John, Indiana |
| Authorized Official Name and Position | Scott A Kapers (DDS) |
| Authorized Official Contact | 2193229920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creating Smiles Pc 8217 Wicker Ave St John IN 46373 Ph: (219) 322-9920 | Creating Smiles Pc 8217 Wicker Ave St John IN 46373 Ph: (219) 322-9920 |
| NPI Number | 1528483021 |
|---|---|
| Provider Enumeration Date | 02/20/2014 |
| Last Update Date | 02/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528483021 | NPI | - | NPPES |
| 100148080 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12011967A (Indiana) | Secondary |
| 1223G0001X | Dentist - General Practice | 12009570 (Indiana) | Primary |