Healthcare Provider Details

I. General information

NPI: 1205084159
Provider Name (Legal Business Name): ALL IN THE FAMILY DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 LINCOLN AVE
EVANSVILLE IN
47714-1047
US

IV. Provider business mailing address

1212 LINCOLN AVE
EVANSVILLE IN
47714-1047
US

V. Phone/Fax

Practice location:
  • Phone: 812-423-6113
  • Fax:
Mailing address:
  • Phone: 812-423-6113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. ADAM L FROUNFELTER
Title or Position: OWNER
Credential: DDS
Phone: 812-423-6113