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General NPI Number Information
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NPI Number | 1467835413
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Entity Type | Organization
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Legal Business Name | SENG PEDIATRIC DENTISTRY, PC
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 07/08/2015
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Provider Practice Location Address
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Address Line | 2005 SAINT CHARLES ST STE 1
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City | JASPER
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State | IN
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Zip | 47546-2271
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Country | US
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Telephone | 812-634-7409
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Fax |
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Provider Business Mailing Address
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Address Line | 2005 SAINT CHARLES ST STE 1
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City | JASPER
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State | IN
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Zip | 47546-2271
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LAURA SENG
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Credential |
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Telephone | 812-634-7409
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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 |
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License Number State |
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