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General NPI Number Information
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NPI Number | 1093809253
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Entity Type | Organization
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Legal Business Name | CHILDRENS DENTAL CARE PC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1239 STATE RD 229
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City | BATESVILLE
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State | IN
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Zip | 47006-6804
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Country | US
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Telephone | 812-934-6166
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Fax | 812-933-0607
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Provider Business Mailing Address
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Address Line | 1239 STATE RD 229
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City | BATESVILLE
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State | IN
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Zip | 47006-6804
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Country | US
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Telephone | 812-934-6166
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Fax | 812-933-0607
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Authorized Official
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Title or Position | TREATMENT COORDINATOR BUSINESS OFF
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Name | MRS. CATHY J SCHNEIDER
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Credential |
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Telephone | 812-934-6166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 8698
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License Number State | IN
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