Organization
KDG INDIANA ONE LLC
Active
Parent organization
KENTUCKIANA DENTAL GROUP
Other names
Garcia Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENTUCKIANA DENTAL GROUP
Authorized official
ADRIENNE NICHOLSON (FINANCIAL COORDINATOR)
(812) 523-1860
Entity
Organization
Contact information
Practice address
321 W BRUCE ST STE A, SEYMOUR, IN 47274-2319
(812) 523-1860
Mailing address
PO BOX 305, SEYMOUR, IN 47274-0305
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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