Provider Demographics
NPI:1174799845
Name:DYER DENTAL PROFESSIONALS, INC.
Entity type:Organization
Organization Name:DYER DENTAL PROFESSIONALS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST -- PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:TAMBRINI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-418-3618
Mailing Address - Street 1:2037 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1729
Mailing Address - Country:US
Mailing Address - Phone:219-865-5040
Mailing Address - Fax:
Practice Address - Street 1:2037 CHURCH ST
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1729
Practice Address - Country:US
Practice Address - Phone:219-865-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010864A261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental