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Contact Information

ADVANCED DENTAL
15285 W 101ST AVE
SUITE H
DYER, IN46311-3035
 Phone: 219-365-5420
 Fax: 219-365-5448
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ADVANCED DENTAL · (Female)

NPI Number 1528118148
Status Active
Credentials
Entity Individual
Enumeration date 01/12/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 12010023A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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