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1093715963
LLYNDALL RHETT FAGG
MICHIGAN CITY, IN
NPI
1093715963
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223P0221X Dentist Pediatric Dentistry
(Licence: IN 12007148A)
Enumeration Date
2005-07-21
Last Update Date
2012-09-12
Business Address
DR. LLYNDALL RHETT FAGG DDS MSD
211 MEDICAL PLZ
MICHIGAN CITY, IN 46360-3364
Phone number: 219-879-4559
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Mailing Address
DR. LLYNDALL RHETT FAGG DDS MSD
211 MEDICAL PLZ
MICHIGAN CITY, IN 46360-3364
Phone number: 219-879-4559
Copy
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