Individual
ANTHONY D KIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
6150 E 82ND ST, INDIANAPOLIS, IN 46250-1500
(317) 207-6480
Mailing address
621 DANVER LN, BEECH GROVE, IN 46107-3328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012307A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2015
Last updated
09/25/2015
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