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Organization
KIDS ENT OF INDIANA LLC
Active
Organization
KIDS ENT OF INDIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN TRIGG MD (PRESIDENT)
(773) 386-7035
Entity
Organization
Contact information
Practice address
8240 NAAB RD STE 150, INDIANAPOLIS, IN 46260-1974
(317) 903-4675
(317) 614-7154
Mailing address
10111 DITCH RD, CARMEL, IN 46032-8897
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200859540
—
IN
Enumeration date
02/22/2018
Last updated
05/10/2022
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