# ADVANCED DENTAL CARE OF ANDERSON LLC

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

## Provider details

- **NPI number:** 1952960916
- **Authorized official:** DR. JACK SUMMERLIN III DDS (OWNER)
- **Authorized official phone:** (317) 409-8819

## Contact information

- **Practice address:** 1612 E 53RD ST, ANDERSON, IN 46013-2826
- **Practice address phone:** (765) 622-7000
- **Mailing address:** 11333 MIRADOR LN, FISHERS, IN 46037-8687
- **Mailing address phone:** (317) 409-8819

## Taxonomy

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

## Other

- **Enumeration date:** 06/12/2019
- **Last updated:** 07/09/2019