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General NPI Number Information
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NPI Number | 1326846965
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Entity Type | Organization
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Legal Business Name | URGENT DENTAL CENTER FORT WAYNE LLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 4646 W JEFFERSON BLVD STE 140
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City | FORT WAYNE
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State | IN
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Zip | 46804-6832
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Country | US
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Telephone | 317-399-5771
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Fax |
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Provider Business Mailing Address
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Address Line | 2907 KENTUCKY AVE STE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46221-2103
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Country | US
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Telephone | 317-399-5771
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REKHA CHAUDHARI
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Credential | DDS
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Telephone | 847-894-0631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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