Individual
SEGHEN AMANIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5330 W WASHINGTON ST, INDIANAPOLIS, IN 46241-2147
(317) 243-1111
Mailing address
1552 RED DUNES RUN, AVON, IN 46123-6404
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.032701
IL
1223G0001X
General Practice Dentistry
Primary
12013570A
IN
1223G0001X
General Practice Dentistry
2020023698
MO
Other
Enumeration date
07/14/2020
Last updated
06/28/2021
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