Organization
GOAD FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE WESTRA DMD (OWNER)
(217) 348-7770
Entity
Organization
Contact information
Practice address
6904 S EAST ST STE F, INDIANAPOLIS, IN 46227-2694
(317) 788-4239
Mailing address
522 E JASPER ST, PARIS, IL 61944-2437
(217) 463-4110
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/04/2021
Last updated
03/04/2021
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