| Healthy Smiles Nwi | |
|
4629 Melton Rd. Gary IN 46403 | |
| (219) 938-2637 | |
| (219) 938-6338 |
| Full Name | Healthy Smiles Nwi |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4629 Melton Rd., Gary, Indiana |
| Authorized Official Name and Position | Nicholas Bernard Cain (CEO) |
| Authorized Official Contact | 6152603544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Smiles Nwi 4629 Melton Rd. Gary IN 46403 Ph: (219) 938-2637 | Healthy Smiles Nwi 4629 Melton Rd. Gary IN 46403 Ph: (219) 938-2637 |
| NPI Number | 1003172008 |
|---|---|
| Provider Enumeration Date | 04/04/2012 |
| Last Update Date | 01/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003172008 | NPI | - | NPPES |
| 200992160 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12011235A (Indiana) | Primary |
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