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General NPI Number Information
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NPI Number | 1346298494
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Entity Type | Organization
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Legal Business Name | WABASH VALLEY CHILDREN'S DENTISTRY
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 440 E. HOSPITAL LANE
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City | TERRE HAUTE
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State | IN
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Zip | 47802
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Country | US
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Telephone | 812-234-5437
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Fax | 812-232-0039
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Provider Business Mailing Address
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Address Line | 440 E. HOSPITAL LANE
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City | TERRE HAUTE
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State | IN
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Zip | 47802
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Country | US
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Telephone | 812-234-5437
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Fax | 812-232-0039
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. DEBORAH ANN BAYSINGER
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Credential |
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Telephone | 812-234-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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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 |
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License Number State |
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