# BRIGHT SIDE DENTAL - INDIANAPOLIS KEYSTONE AVENUE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336525567
- **Authorized official:** ABRAHAM GERSHONOWICZ DDS (OWNER)
- **Authorized official phone:** (317) 731-6636

## Contact information

- **Practice address:** 7102 N KEYSTONE AVE, INDIANAPOLIS, IN 46240-3242
- **Practice address phone:** (317) 731-6636
- **Practice address fax:** (317) 731-6569
- **Mailing address:** 7102 N KEYSTONE AVE, INDIANAPOLIS, IN 46240-3242
- **Mailing address phone:** (317) 731-6636
- **Mailing address fax:** (317) 731-6569

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12011992A | IN | Yes |

## Other

- **Enumeration date:** 08/11/2015
- **Last updated:** 08/11/2015