Indiana Pediatric Dental & Anesthesia Llc is a Pediatric Dental Clinic in Fort Wayne, Indiana. It is located at 3030 Lake Ave Ste 15, Fort Wayne, IN and its contact number is 512-902-9997. The authorized person for Indiana Pediatric Dental & Anesthesia Llc is Lucian Dan Boboia
who is Owner of the clinic and their contact number is 512-902-9997. Indiana Pediatric Dental & Anesthesia Llc Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Indiana Pediatric Dental & Anesthesia Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Indiana Pediatric Dental & Anesthesia Llc
Specialization:
Pediatric Dentistry
Clinic Address:
3030 Lake Ave Ste 15, Fort Wayne, Indiana, 46805-5428
Phone:
512-902-9997
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Lucian Dan Boboia
Position:
Owner
Contact Number:
512-902-9997
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Indiana Pediatric Dental & Anesthesia Llc clinic are as mentioned below.
NPI Number:
1164016127
NPI Enumeration Date:
21 Feb, 2021
NPI Last Update On:
21 Feb, 2021
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Indiana Pediatric Dental & Anesthesia Llc are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
12010910A
Other
Indiana
State Of Indiana Dentistry Board
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Indiana Pediatric Dental & Anesthesia Llc 3030 Lake Ave Ste 15, Fort Wayne, Indiana
Zip:
46805-5428
Phone Number:
512-902-9997
Patients can reach Indiana Pediatric Dental & Anesthesia Llc at 3030 Lake Ave Ste 15, Fort Wayne, Indiana or can call to book an appointment on 512-902-9997. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.