Provider Demographics
NPI:1700115797
Name:CAVE AND CAVE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:CAVE AND CAVE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:N
Authorized Official - Last Name:CAVE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:812-936-2929
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:FRENCH LICK
Mailing Address - State:IN
Mailing Address - Zip Code:47432-0151
Mailing Address - Country:US
Mailing Address - Phone:812-936-2929
Mailing Address - Fax:812-936-2992
Practice Address - Street 1:9571 W STATE ROAD 56
Practice Address - Street 2:
Practice Address - City:FRENCH LICK
Practice Address - State:IN
Practice Address - Zip Code:47432-9708
Practice Address - Country:US
Practice Address - Phone:812-936-3939
Practice Address - Fax:812-936-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100194610AMedicaid
IN200856160AMedicaid