Organization
MITRA NIKPOUR; D.D.S. LLC
Active
Other names
INDIANA DENTAL CENTER ON SHERMAN
Organization subpart
No
Provider details
NPI number
Authorized official
MITRA NIKPOUR D.D.S. (OWNER)
(317) 545-6011
Entity
Organization
Contact information
Practice address
3628 N SHERMAN DR, INDIANAPOLIS, IN 46218-1436
(317) 545-6011
Mailing address
PO BOX 301014, INDIANAPOLIS, IN 46230-1014
(832) 618-6647
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011731A
IN
Other
Enumeration date
05/09/2013
Last updated
05/09/2013
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