Provider Demographics
NPI:1568938629
Name:WESTVILLE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:WESTVILLE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:219-613-7828
Mailing Address - Street 1:444 N FLYNN RD
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46391-9647
Mailing Address - Country:US
Mailing Address - Phone:219-613-7828
Mailing Address - Fax:219-785-4000
Practice Address - Street 1:444 N FLYNN RD
Practice Address - Street 2:
Practice Address - City:WESTVILLE
Practice Address - State:IN
Practice Address - Zip Code:46391-9647
Practice Address - Country:US
Practice Address - Phone:219-613-7828
Practice Address - Fax:219-785-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental