Provider Demographics
NPI:1710273099
Name:NEW PARIS FAMILY DENTISTRY INC
Entity Type:Organization
Organization Name:NEW PARIS FAMILY DENTISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:574-831-4477
Mailing Address - Street 1:67470 FERNBROOK RD
Mailing Address - Street 2:
Mailing Address - City:NEW PARIS
Mailing Address - State:IN
Mailing Address - Zip Code:46553-9761
Mailing Address - Country:US
Mailing Address - Phone:574-831-4477
Mailing Address - Fax:574-831-4488
Practice Address - Street 1:67470 FERNBROOK RD
Practice Address - Street 2:
Practice Address - City:NEW PARIS
Practice Address - State:IN
Practice Address - Zip Code:46553-9761
Practice Address - Country:US
Practice Address - Phone:574-831-4477
Practice Address - Fax:574-831-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009975122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty