MEDICARE: SCHERERVILLE FAMILY DENTISTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1316155070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHERERVILLE FAMILY DENTISTRY

Provider Business Mailing Address
First Line	:	2001 US HIGHWAY 41
Second Line	:	SUITE M
City	:	SCHERERVILLE
State	:	IN
Zip	:	46375-2892
Country	:	US
Telephone Number	:	219-322-3232
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 US HIGHWAY 41
Second Line	:	SUITE M
City	:	SCHERERVILLE
State	:	IN
Zip	:	46375-2892
Country	:	US
Telephone Number	:	219-322-3232
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RATOMIR ALAVANJA
Credential	:	DDS
Telephone Number	:	219-322-3232

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	08/22/2020

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