Organization
KB DENTAL GROUP III, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY COAD (OFFICE MANAGER)
(317) 570-5480
Entity
Organization
Contact information
Practice address
141 N SHORTRIDGE RD, INDIANAPOLIS, IN 46219-8906
(317) 357-4018
Mailing address
141 N SHORTRIDGE RD, INDIANAPOLIS, IN 46219-8906
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010486
IN
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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