Organization
SANDCREST DENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCIANA KANO-WILSON D.D.S. (CO-OWNER)
(812) 372-6165
Entity
Organization
Contact information
Practice address
2525 SANDCREST BLVD, COLUMBUS, IN 47203-3048
(812) 372-6165
(812) 372-3065
Mailing address
2525 SANDCREST BLVD, COLUMBUS, IN 47203-3048
(812) 372-6165
(812) 372-3065
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011382
IN
Other
Enumeration date
01/31/2014
Last updated
01/31/2014
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