Provider Demographics
NPI:1346320850
Name:CHRISTINA WROBLEWSKI, DDS, PC
Entity Type:Organization
Organization Name:CHRISTINA WROBLEWSKI, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WROBLEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PC
Authorized Official - Phone:765-644-1000
Mailing Address - Street 1:3814 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-4058
Mailing Address - Country:US
Mailing Address - Phone:765-644-1000
Mailing Address - Fax:765-644-1904
Practice Address - Street 1:3814 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-4058
Practice Address - Country:US
Practice Address - Phone:765-644-1000
Practice Address - Fax:765-644-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN=========OtherTAX ID NUMBER