| The Dental Center Of South Bend Llc | |
|
1005 E Lasalle Ave South Bend IN 46617-2818 | |
| (574) 245-7501 | |
| (574) 245-7502 |
| Full Name | The Dental Center Of South Bend Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1005 E Lasalle Ave, South Bend, Indiana |
| Authorized Official Name and Position | Charles Rosenbaum (DENTALDIRECTOR) |
| Authorized Official Contact | 5742457501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Dental Center Of South Bend Llc 1005 E Lasalle Ave South Bend IN 46617-2818 Ph: (574) 245-7501 | The Dental Center Of South Bend Llc 1005 E Lasalle Ave South Bend IN 46617-2818 Ph: (574) 245-7501 |
| NPI Number | 1538184460 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538184460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 12015961 (Indiana) | Primary |
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