NPI 1396136511

5th Ave Dental INC.

Organisation General Practice Dentistry Gary, IN

Practice location

Address: 1619 W 5th Ave, Gary, IN 46404-1506
Phone: (708) 359-2068
Mailing address: 814 W Chicago Ave, East Chicago, IN 46312-3307

Authorised official

Name: Amit Saparia
Title: President
Phone: (708) 359-2068

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 12011381 (IN)

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Registry record

NPI: 1396136511
Entity type: Organization
NPI issued: 10 Feb 2015
Record last updated: 10 Feb 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.