Organization
KB DENTAL, LLC
Active
Other names
Simply Smile
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL BACON (PARTNER)
(317) 570-5480
Entity
Organization
Contact information
Practice address
3750 N MERIDIAN ST STE 200, INDIANAPOLIS, IN 46208-4300
(317) 570-5480
Mailing address
5362 N ILLINOIS ST, INDIANAPOLIS, IN 46208-2638
(317) 570-5480
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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