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Organization
BACSA DENTAL PC
Active
Organization
BACSA DENTAL PC
Active
Other names
Emerson Avenue Detnal
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY BACSA DDS (PRESIDENT)
(317) 258-0309
Entity
Organization
Contact information
Practice address
4625 S EMERSON AVE, INDIANAPOLIS, IN 46203-5972
(317) 784-5555
Mailing address
8805 KNOTTY PINE CT, INDIANAPOLIS, IN 46227-9764
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
12010741A
IN
Other
Enumeration date
08/11/2009
Last updated
08/11/2009
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