Organization
WARRICK PARK DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JED MARLIN INMAN D.D.S. (OWNER/DENTIST)
(812) 897-4889
Entity
Organization
Contact information
Practice address
800 OFFICE PARK DR, BOONVILLE, IN 47601-8601
(812) 897-4889
(812) 897-8113
Mailing address
800 OFFICE PARK DR, BOONVILLE, IN 47601-8601
(812) 897-4889
(812) 897-8113
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12011465A
IN
1223G0001X
General Practice Dentistry
Primary
7613
IN
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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