| Dr. L Gary Painter Pc | |
|
4109 Lahmeyer Rd Fort Wayne IN 46815-5666 | |
| (260) 486-3100 | |
| (260) 486-0068 |
| Full Name | Dr. L Gary Painter Pc |
|---|---|
| Speciality | Dentist |
| Location | 4109 Lahmeyer Rd, Fort Wayne, Indiana |
| Authorized Official Name and Position | L. Gary Painter (OWNER) |
| Authorized Official Contact | 2604863100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. L Gary Painter Pc 4109 Lahmeyer Rd Fort Wayne IN 46815-5666 Ph: (260) 486-3100 | Dr. L Gary Painter Pc 4109 Lahmeyer Rd Fort Wayne IN 46815-5666 Ph: (260) 486-3100 |
| NPI Number | 1639501273 |
|---|---|
| Provider Enumeration Date | 08/06/2013 |
| Last Update Date | 08/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639501273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12008216A (Indiana) | Primary |
| 122300000X | Dentist | 12011943A (* (Not Available)) | Secondary |
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