Organization
SERENITY CREEK DENTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ELIKOFER DDS (OWNER / DENTIST)
(317) 417-1221
Entity
Organization
Contact information
Practice address
298 S 10TH ST STE 100, NOBLESVILLE, IN 46060-2741
(317) 417-1221
Mailing address
298 S 10TH ST STE 100, NOBLESVILLE, IN 46060-2741
(317) 417-1221
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12012146A
IN DENTAL LICENSE
IN
01
—
1881008399
NPI TYPE 1
IN
Enumeration date
04/18/2022
Last updated
04/18/2022
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