# EAST 53RD STREET DENTAL-2, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kool Smiles, Kool Smiles INI-2,PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881778801
- **Authorized official:** DR. DAVID VIETH (CHIEF DENTAL OFFICER)
- **Authorized official phone:** (770) 916-9000

## Contact information

- **Practice address:** 2248 E 53RD ST, INDIANAPOLIS, IN 46220-3479
- **Practice address phone:** (317) 472-9888
- **Practice address fax:** (317) 257-7028
- **Mailing address:** 1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
- **Mailing address phone:** (770) 916-5036
- **Mailing address fax:** (678) 285-4760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 05/13/2019