| Henry K Pong, Dds, Psc | |
|
3820 Central Ave Lake Station IN 46405-2324 | |
| (219) 962-8666 | |
| Not Available |
| Full Name | Henry K Pong, Dds, Psc |
|---|---|
| Speciality | Dentist |
| Location | 3820 Central Ave, Lake Station, Indiana |
| Authorized Official Name and Position | Henry K Pong (PRESIDENT) |
| Authorized Official Contact | 2199628666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Henry K Pong, Dds, Psc 3820 Central Ave Lake Station IN 46405-2324 Ph: (219) 962-8666 | Henry K Pong, Dds, Psc 3820 Central Ave Lake Station IN 46405-2324 Ph: (219) 962-8666 |
| NPI Number | 1174620769 |
|---|---|
| Provider Enumeration Date | 09/17/2006 |
| Last Update Date | 02/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174620769 | NPI | - | NPPES |
| 100167920A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 54000645 (Indiana) | Primary |
Secure Dental Iii Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3820 Central Ave # 2324, Lake Station, IN 46405 Phone: 219-962-8666 | |
Northshore Health Centers, Inc. Dental Clinic Medicare: Medicare Enrolled Practice Location: 3099 Central Ave, Lake Station, IN 46405 Phone: 219-763-8112 Fax: 219-962-1189 | |
Reliable Denture Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2370 E 37th Ave, Lake Station, IN 46405 Phone: 219-962-3000 Fax: 219-962-9371 | |
Nikki A Wargo Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2370 E 37th Ave, Lake Station, IN 46405 Phone: 219-962-3000 Fax: 219-962-9571 |