Organization
MANOJ K BAHL, DDS, PC
Active
Other names
Excel Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANOJ K BAHL DDS, PC (OWNER/DENTIST)
(219) 769-3305
Entity
Organization
Contact information
Practice address
40 W 73RD AVE, MERRILLVILLE, IN 46410-3979
(219) 769-3305
(219) 769-4674
Mailing address
40 W 73RD AVE, MERRILLVILLE, IN 46410-3979
(219) 769-3305
(219) 769-4674
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011727A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201300110A
—
IN
Enumeration date
07/09/2015
Last updated
09/16/2015
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