| Detailed Dental | |
|
13963 Morse St Cedar Lake IN 46303-9639 | |
| (219) 374-2400 | |
| Not Available |
| Full Name | Detailed Dental |
|---|---|
| Speciality | Dentist |
| Location | 13963 Morse St, Cedar Lake, Indiana |
| Authorized Official Name and Position | Christine Gudas (OWNER) |
| Authorized Official Contact | 2193742400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Detailed Dental 13963 Morse St Cedar Lake IN 46303-9639 Ph: (219) 374-2400 | Detailed Dental 13963 Morse St Cedar Lake IN 46303-9639 Ph: (219) 374-2400 |
| NPI Number | 1215267661 |
|---|---|
| Provider Enumeration Date | 01/07/2010 |
| Last Update Date | 01/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215267661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12011020 (Indiana) | Primary |
Cedar Lake Dental Center, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13955 Morse St, Cedar Lake, IN 46303 Phone: 219-374-5591 Fax: 219-662-2573 | |
Moody Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13955 Morse St, Cedar Lake, IN 46303 Phone: 219-374-5591 Fax: 219-374-5592 |