| Terre Haute Periodontics | |
|
221 S 19th St Terre Haute IN 47807-4129 | |
| (812) 232-0064 | |
| (812) 232-3834 |
| Full Name | Terre Haute Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 221 S 19th St, Terre Haute, Indiana |
| Authorized Official Name and Position | James M Humphrey (PRESIDENT) |
| Authorized Official Contact | 8122320064 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Terre Haute Periodontics 221 S 19th St Terre Haute IN 47807-4129 Ph: (812) 232-0064 | Terre Haute Periodontics 221 S 19th St Terre Haute IN 47807-4129 Ph: (812) 232-0064 |
| NPI Number | 1346278710 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346278710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 12009022A (Indiana) | Primary |
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