# KIDS & ADULT DENTAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KIDS & ADULT DENTAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679398424
- **Authorized official:** MRS. BRANDI MARIE BIBB (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (317) 605-8367

## Contact information

- **Practice address:** 1030 COUNTRY CLUB RD, INDIANAPOLIS, IN 46234-1813
- **Practice address phone:** (317) 991-4725
- **Mailing address:** 1030 COUNTRY CLUB RD, INDIANAPOLIS, IN 46234-1813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/18/2024
- **Last updated:** 11/18/2024