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General NPI Number Information
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NPI Number | 1013534486
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Entity Type | Individual
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Provider Name | ALISON LANDGRAF DMD
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Gender | Female
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 1128 WABASH AVE
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City | TERRE HAUTE
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State | IN
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Zip | 47807-3212
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Country | US
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Telephone | 812-234-2488
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Fax |
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Provider Business Mailing Address
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Address Line | 1242 OTIS DR
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City | NILES
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State | MI
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Zip | 49120-8928
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Country | US
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Telephone | 574-807-1526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 016.0133961
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 121014619A
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License Number State | IN
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