Organization
KNOP FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MEEK (BUSINESS MANAGER)
(765) 337-2167
Entity
Organization
Contact information
Practice address
709 S 18TH ST, STE E, LAFAYETTE, IN 47905-1575
(765) 426-0149
Mailing address
709 S 18TH ST, STE E, LAFAYETTE, IN 47905-1575
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010499A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200444470
—
IN
Enumeration date
07/24/2013
Last updated
07/25/2013
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