Healthcare Provider Details

I. General information

NPI: 1588895585
Provider Name (Legal Business Name): HI-TEK SMILES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2009
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 E US HIGHWAY 30
SCHERERVILLE IN
46375-2116
US

IV. Provider business mailing address

175 E US HIGHWAY 30
SCHERERVILLE IN
46375-2116
US

V. Phone/Fax

Practice location:
  • Phone: 219-322-1852
  • Fax: 219-322-1872
Mailing address:
  • Phone: 219-322-1852
  • Fax: 219-322-1872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number54001643A
License Number StateIN

VIII. Authorized Official

Name: DR. KEVIN A. NATT
Title or Position: OWNER/PRESIDENT
Credential: D.D.S.
Phone: 219-322-1852