Llyndall Rhett Fagg in Michigan City - Pediatric Dentistry
Llyndall Rhett Fagg - NPI 1093715963
Llyndall Rhett Fagg is a Pediatric Dentistry in Michigan City, Indiana. Llyndall Rhett Fagg practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Llyndall Rhett Fagg is 1093715963. The last update date is 2012-09-12.
Llyndall Rhett Fagg's current location address is 211 Medical Plz, Michigan City, Indiana. You can contact this provider via phone number 2198794559 and fax number 2198794559. The mailing address for Llyndall Rhett Fagg is 211 Medical Plz, Michigan City, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Llyndall Rhett Fagg |
|---|---|
| Address | 211 Medical Plz, Michigan City, Indiana |
| Phone Number | 2198794559 |
| Fax Number | 2198794559 |
| Sole Proprietor | N |
| Credentials | DDS MSD |
NPI Number Detail
| NPI Number | 1093715963 |
|---|---|
| Provider Enumeration Date | 2005-07-21 |
| Last Updated Date | 2012-09-12 |
Provider Mailing Address Detail
| Address | 211 Medical Plz |
|---|---|
| City | Michigan City |
| State | Indiana (IN) |
| Post Code | 463603364 |
| Phone Number | 2198794559 |
| Fax Number | 2198794559 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 12007148A |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200365570 | IN | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Llyndall Rhett Fagg by the Centers for Medicare & Medicaid Services (CMS)?
The Llyndall Rhett Fagg has been assigned the NPI (National Provider Identifier) 1093715963. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Llyndall Rhett Fagg located?
The Llyndall Rhett Fagg is located at 211 Medical Plz, Michigan City, IN 463603364.
What is the area of specialization for Llyndall Rhett Fagg, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Llyndall Rhett Fagg is Pediatric Dentistry, and the corresponding taxonomy code that categorizes this area of expertise is 1223P0221X.
When was the Llyndall Rhett Fagg's 1093715963 issued?
The Llyndall Rhett Fagg's 1093715963 was issued on 2005-07-21.
When was the Llyndall Rhett Fagg's information last updated?
The Llyndall Rhett Fagg's information was last updated on 2012-09-12.