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General NPI Number Information
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NPI Number | 1700693991
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Entity Type | Organization
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Legal Business Name | SPRINGER DENTAL CARE OF MISHAWAKA LLC
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 16081 JACKSON RD
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City | MISHAWAKA
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State | IN
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Zip | 46544-9343
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Country | US
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Telephone | 574-291-2132
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Fax | 574-257-2063
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Provider Business Mailing Address
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Address Line | 3702 E MISHAWAKA RD
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City | ELKHART
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State | IN
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Zip | 46517-3550
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Country | US
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Telephone | 574-291-2132
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Fax | 574-257-2063
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | TROY SPRINGER
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Credential | DDS
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Telephone | 574-875-6595
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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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