Dental Services Of Indiana, P.C.
Dentist, General Practice in Indianapolis, IN. Organization (NPI-2).
NPI number1982135174
StatusActive
Last updated in NPPESMay 1, 2017
Details
- NPI
- 1982135174
- Entity type
- Organization (NPI-2)
- Legal business name
- Dental Services Of Indiana, P.C.
- Organization subpart
- Yes
- Enumeration date
- Mar 21, 2017
- Last updated
- May 1, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Immediadent (Doing Business As)
Practice location
4960 S Emerson AveIndianapolis, IN 46203-5937
Phone 317-324-4333 · Fax 866-591-0604
Mailing address
Po Box 11568Overland Park, KS 66207-4268
Phone 913-428-1686 · Fax 866-591-0604
Authorized official
Monica L Long
Manager Of Provider Credentialing
9134281686
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