| Wabash Dental Services LLC | |
|
278 Manchester Ave Wabash IN 46992-1808 | |
| (260) 563-4065 | |
| (260) 563-4193 |
| Full Name | Wabash Dental Services LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 278 Manchester Ave, Wabash, Indiana |
| Authorized Official Name and Position | Mary Anne Bain (OWNER) |
| Authorized Official Contact | 2605634065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wabash Dental Services LLC 278 Manchester Ave Wabash IN 46992-1808 Ph: (260) 563-4065 | Wabash Dental Services LLC 278 Manchester Ave Wabash IN 46992-1808 Ph: (260) 563-4065 |
| NPI Number | 1316176803 |
|---|---|
| Provider Enumeration Date | 07/07/2009 |
| Last Update Date | 07/07/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316176803 | NPI | - | NPPES |
| 1223G0001X | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | IN12007971 (Indiana) | Primary |
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