Provider Demographics
NPI:1790988418
Name:A & A DENTAL CENTER
Entity Type:Organization
Organization Name:A & A DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CRESHINDA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:AYANGADE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:219-795-9999
Mailing Address - Street 1:7880 BROADWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5566
Mailing Address - Country:US
Mailing Address - Phone:219-795-9999
Mailing Address - Fax:219-795-9590
Practice Address - Street 1:7880 BROADWAY
Practice Address - Street 2:SUITE A
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5566
Practice Address - Country:US
Practice Address - Phone:219-795-9999
Practice Address - Fax:219-795-9590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty