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Organization
86TH STREET COMPLETE DENTAL LLC
Active
Organization
86TH STREET COMPLETE DENTAL LLC
Active
Other names
86TH STREET Complete Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MONA P SINGH (OWNER)
(317) 748-4603
Entity
Organization
Contact information
Practice address
3810 W 86TH ST, INDIANAPOLIS, IN 46268
(317) 707-6453
Mailing address
3810 W 86TH ST, INDIANAPOLIS, IN 46268-1905
(317) 707-6453
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300015766
—
IN
Enumeration date
07/13/2017
Last updated
02/26/2024
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