Organization
LIFETIME DENTAL CARE OF INDIANA, PC
Active
Other names
Prairie Lakes Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
AMY KROEGER (INS COOD)
(217) 540-5100
Entity
Organization
Contact information
Practice address
14160 MUNDY DRIVE, SUITE 1200, NOBLESVILLE, IN 46060
(317) 774-1600
(317) 774-1980
Mailing address
14160 MUNDY DRIVE, SUITE 1200, NOBLESVILLE, IN 46060
(317) 774-1600
(317) 774-1980
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
08/22/2020
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