Provider Demographics
NPI:1093547838
Name:LOTUS DENTAL INC
Entity type:Organization
Organization Name:LOTUS DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST - PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARI PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:574-345-0345
Mailing Address - Street 1:6502 GRAPE RD STE 882
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-1102
Mailing Address - Country:US
Mailing Address - Phone:574-345-0345
Mailing Address - Fax:574-345-0344
Practice Address - Street 1:6502 GRAPE RD STE 882
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-1102
Practice Address - Country:US
Practice Address - Phone:574-345-0345
Practice Address - Fax:574-345-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty