Provider Demographics
NPI:1336302975
Name:LANGEVIN, ERIN MICHELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MICHELLE
Last Name:LANGEVIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WALTER REMLEY DR
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-3350
Mailing Address - Country:US
Mailing Address - Phone:765-267-8484
Mailing Address - Fax:765-790-2230
Practice Address - Street 1:114 WALTER REMLEY DR
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-3350
Practice Address - Country:US
Practice Address - Phone:765-267-8484
Practice Address - Fax:765-790-2230
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011395122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist