Provider Demographics
NPI:1467938001
Name:WHITELAND FAMILY DENTAL LLC
Entity Type:Organization
Organization Name:WHITELAND FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-535-5665
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:WHITELAND
Mailing Address - State:IN
Mailing Address - Zip Code:46184-0246
Mailing Address - Country:US
Mailing Address - Phone:317-535-5665
Mailing Address - Fax:317-535-5865
Practice Address - Street 1:119 N US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:WHITELAND
Practice Address - State:IN
Practice Address - Zip Code:46184-1459
Practice Address - Country:US
Practice Address - Phone:317-535-5665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental