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General NPI Number Information
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NPI Number | 1992858658
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Entity Type | Organization
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Legal Business Name | PEDIATRIC DENTISTRY OF NORTHWEST INDIANA PC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 809 WALL ST SUITE D
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City | VALPARAISO
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State | IN
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Zip | 46383-2570
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Country | US
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Telephone | 219-462-8779
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Fax | 219-531-2440
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Provider Business Mailing Address
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Address Line | 809 WALL ST SUITE D
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City | VALPARAISO
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State | IN
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Zip | 46383-2570
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Country | US
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Telephone | 219-462-8779
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Fax | 219-531-2440
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TERRY G. SCHECHNER
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Credential | D.D.S.
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Telephone | 219-462-8779
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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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