Provider Demographics
NPI:1003345216
Name:SPRINGER DENTAL CARE OF MILLERSBURG
Entity Type:Organization
Organization Name:SPRINGER DENTAL CARE OF MILLERSBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:574-971-1532
Mailing Address - Street 1:3702 E MISHAWAKA RD
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-3550
Mailing Address - Country:US
Mailing Address - Phone:574-971-1532
Mailing Address - Fax:
Practice Address - Street 1:422 N BENTON ST
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:46543-9732
Practice Address - Country:US
Practice Address - Phone:574-642-4449
Practice Address - Fax:574-642-3863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011803A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty