Organization · Type 2 NPI
Familia Dental SPFW PLLC
Dental Clinic/Center · Fort Wayne, IN
NPI number
1619388063
Active
Practice location
100 E Pettit Ave, 1A
Fort Wayne, IN 46806-3003
Fax (847) 496-7603
Mailing address
2050 E Algonquin Rd, Suite 610
Schaumburg, IL 60173-4144
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1619388063
Familia Dental SPFW PLLC's National Provider Identifier is 1619388063, issued on May 19, 2014. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Fort Wayne, IN. The record was last updated on Oct 15, 2021.