Organization
INDIANA DENTAL SLEEP THERAPY LLC
Active
Other names
Koala Center for Sleep Disorders IN-2
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE COPE DDS, MSD (OWNER)
(317) 640-7907
Entity
Organization
Contact information
Practice address
4921 SR 26 E, SUITE 300, LAFAYETTE, IN 47905
(309) 243-8980
Mailing address
4921 SR 26 E, SUITE 300, LAFAYETTE, IN 47905
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011052A
IN
Other
Enumeration date
08/28/2015
Last updated
05/16/2016
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