Provider Demographics
NPI:1811563794
Name:ARBOR DENTAL LLC
Entity Type:Organization
Organization Name:ARBOR DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-477-6100
Mailing Address - Street 1:2 WALTER SCHOLER DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-6382
Mailing Address - Country:US
Mailing Address - Phone:765-477-6100
Mailing Address - Fax:
Practice Address - Street 1:2 WALTER SCHOLER DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-6382
Practice Address - Country:US
Practice Address - Phone:765-477-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental