| Terre Haute Endodontics Pc | |
|
221 S 19th St Terre Haute IN 47807-4129 | |
| (812) 235-1598 | |
| (812) 235-1999 |
| Full Name | Terre Haute Endodontics Pc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 221 S 19th St, Terre Haute, Indiana |
| Authorized Official Name and Position | Patricia H Clark (DR PATRICIA H CLARK) |
| Authorized Official Contact | 8122351598 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Terre Haute Endodontics Pc 221 S 19th St Terre Haute IN 47807-4129 Ph: (812) 235-1598 | Terre Haute Endodontics Pc 221 S 19th St Terre Haute IN 47807-4129 Ph: (812) 235-1598 |
| NPI Number | 1730116112 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 07/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730116112 | NPI | - | NPPES |
| 100065720A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
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