| Lighthouse Dental | |
|
556 N Oak Rd Plymouth IN 46563-1664 | |
| (574) 936-3921 | |
| (574) 936-1010 |
| Full Name | Lighthouse Dental |
|---|---|
| Speciality | Dentist |
| Location | 556 N Oak Rd, Plymouth, Indiana |
| Authorized Official Name and Position | Bruce F Becker (PRESIDENT) |
| Authorized Official Contact | 5749363921 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Dental 556 N Oak Rd Plymouth IN 46563-1664 Ph: (574) 936-3921 | Lighthouse Dental 556 N Oak Rd Plymouth IN 46563-1664 Ph: (574) 936-3921 |
| NPI Number | 1861410318 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 11/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861410318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12009200 (Indiana) | Primary |
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