Organization
MEC DENTAL MANAGEMENT LLC
Active
Other names
Keystone Family Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW EDWARD CHURCH DDS (OWNER/DENTIST)
(317) 252-5480
Entity
Organization
Contact information
Practice address
5426 N KEYSTONE AVE, INDIANAPOLIS, IN 46220-3456
(317) 252-5480
(317) 252-5482
Mailing address
5426 N KEYSTONE AVE, INDIANAPOLIS, IN 46220-3456
(317) 252-5480
(317) 252-5482
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010045
IN
Other
Enumeration date
07/21/2010
Last updated
07/21/2010
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