# WALNUT STREET TOTAL DENTAL LLC

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

## Provider details

- **NPI number:** 1457164071
- **Authorized official:** DEEPT RANA DDS (MANAGER)
- **Authorized official phone:** (734) 369-7375

## Contact information

- **Practice address:** 601 E WALNUT ST, FRANKFORT, IN 46041-2562
- **Practice address phone:** (765) 659-4977
- **Mailing address:** 3611 W 16TH ST, INDIANAPOLIS, IN 46222-2501
- **Mailing address phone:** (734) 369-7375

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/28/2025
- **Last updated:** 01/28/2025