Provider Demographics
NPI:1891029310
Name:RELIANT FAMILY DENTAL
Entity Type:Organization
Organization Name:RELIANT FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MEUNIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:812-402-7676
Mailing Address - Street 1:4827 DAVIS LANT DR
Mailing Address - Street 2:STE #G
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-8946
Mailing Address - Country:US
Mailing Address - Phone:812-402-7676
Mailing Address - Fax:812-402-7979
Practice Address - Street 1:4827 DAVIS LANT DR
Practice Address - Street 2:STE #G
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-8946
Practice Address - Country:US
Practice Address - Phone:812-402-7676
Practice Address - Fax:812-402-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010454A261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental