Provider Demographics
NPI:1770186462
Name:ACI DENTAL LLC
Entity Type:Organization
Organization Name:ACI DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:BIXLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:260-341-5020
Mailing Address - Street 1:210 W WHITLEY ST
Mailing Address - Street 2:
Mailing Address - City:CHURUBUSCO
Mailing Address - State:IN
Mailing Address - Zip Code:46723-1720
Mailing Address - Country:US
Mailing Address - Phone:260-693-9300
Mailing Address - Fax:260-693-1376
Practice Address - Street 1:210 W WHITLEY ST
Practice Address - Street 2:
Practice Address - City:CHURUBUSCO
Practice Address - State:IN
Practice Address - Zip Code:46723-1720
Practice Address - Country:US
Practice Address - Phone:260-693-9300
Practice Address - Fax:260-693-1376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental