Bewick Dental Corp

Organization Active NPI General Practice Dentistry · Portage, IN

NPI 1295930196 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1295930196
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
12008296A (IN)
Legal business name
BEWICK DENTAL CORP
Practice address
3410 Willowcreek Rd
Portage, IN 46368-5089
Phone
(219) 762-5288
Fax
(219) 763-3369
NPI assigned
Jun 19, 2007
Organization subpart
No

Authorized official

Name
Dr. Robert Kent Bewick, D.D.S.
Title
Owner
Phone
(219) 762-5288

National Provider Directory

Locations

3410 Willowcreek Rd
Portage, IN 46368
Phone (219) 364-6753

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 12008296A IN Yes

Addresses

Primary practice location

3410 Willowcreek Rd
Portage, IN 46368-5089

Mailing address

3410 Willowcreek Rd
Portage, IN 46368-5089
Phone (219) 762-5288

Other providers in Portage, IN

All providers in Portage, IN · General Practice Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.