Individual
DR. THANH QUACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
650 N GIRLS SCHOOL RD, INDIANAPOLIS, IN 46214-3672
(317) 209-9702
(317) 209-9703
Mailing address
650 N GIRLS SCHOOL RD, INDIANAPOLIS, IN 46214-3660
(317) 209-9702
(317) 209-9703
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010185
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200239770B
—
IN
Enumeration date
06/16/2006
Last updated
12/31/2021
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