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Organization
ADVANCED DENTAL CARE OF ANDERSON LLC
Active
Organization
ADVANCED DENTAL CARE OF ANDERSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK SUMMERLIN III DDS (OWNER)
(317) 409-8819
Entity
Organization
Contact information
Practice address
1612 E 53RD ST, ANDERSON, IN 46013-2826
(765) 622-7000
Mailing address
11333 MIRADOR LN, FISHERS, IN 46037-8687
(317) 409-8819
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
07/09/2019
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