| Angela Dehaven Dds Llc | |
|
3225 Nichol Ave Anderson IN 46011-3148 | |
| (765) 642-7717 | |
| (765) 649-2111 |
| Full Name | Angela Dehaven Dds Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3225 Nichol Ave, Anderson, Indiana |
| Authorized Official Name and Position | Angela Lynn Dehaven (OWNER) |
| Authorized Official Contact | 7656427717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Dehaven Dds Llc 3225 Nichol Ave Anderson IN 46011-3148 Ph: (765) 642-7717 | Angela Dehaven Dds Llc 3225 Nichol Ave Anderson IN 46011-3148 Ph: (765) 642-7717 |
| NPI Number | 1972901163 |
|---|---|
| Provider Enumeration Date | 12/20/2014 |
| Last Update Date | 12/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972901163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12009405 (Indiana) | Primary |
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