Organization
WEST 38TH DENTAL, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNG H KONG DDS (OWNER)
(317) 297-4502
Entity
Organization
Contact information
Practice address
3808 N LAWNDALE AVE, INDIANAPOLIS, IN 46254-2814
(317) 297-4502
(317) 297-4554
Mailing address
3808 N LAWNDALE AVE, INDIANAPOLIS, IN 46254-2814
(317) 297-4502
(317) 297-4554
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010747A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200533220A
—
IN
Enumeration date
08/06/2014
Last updated
08/06/2014
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