Provider Demographics
NPI:1962507665
Name:WILLIAM F. SMUTZER DDS INC
Entity Type:Organization
Organization Name:WILLIAM F. SMUTZER DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:SMUTZER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:219-924-2860
Mailing Address - Street 1:1644 45TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3970
Mailing Address - Country:US
Mailing Address - Phone:219-924-2860
Mailing Address - Fax:219-924-2860
Practice Address - Street 1:1644 45TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3970
Practice Address - Country:US
Practice Address - Phone:219-924-2860
Practice Address - Fax:219-924-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty