| Ireland Park Dentistry | |
|
1902 E Ireland Rd South Bend IN 46614-2863 | |
| (574) 291-8022 | |
| (574) 291-7868 |
| Full Name | Ireland Park Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1902 E Ireland Rd, South Bend, Indiana |
| Authorized Official Name and Position | Avis L Barker (PARTNER) |
| Authorized Official Contact | 5742918022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ireland Park Dentistry 1902 E Ireland Rd South Bend IN 46614-2863 Ph: (574) 291-8022 | Ireland Park Dentistry 1902 E Ireland Rd South Bend IN 46614-2863 Ph: (574) 291-8022 |
| NPI Number | 1194265553 |
|---|---|
| Provider Enumeration Date | 03/06/2017 |
| Last Update Date | 03/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194265553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12011066A (Indiana) | Primary |
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