Organization
DENTAL PROFESSIONALS OF INDIANA, PC
Active
Parent organization
DENTAL PROFESSIONALS OF INDIANA, PC
Other names
Regal Valley Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF INDIANA, PC
Authorized official
KENDRA WALKER (CREDENTIALING SUPERVISOR)
(217) 821-7249
Entity
Organization
Contact information
Practice address
2000 VETERANS MEMORIAL PARKWAY S, LAFAYETTE, IN 47909
(765) 746-6166
(765) 746-6935
Mailing address
2000 VETERANS MEMORIAL PARKWAY S, LAFAYETTE, IN 47909
(765) 746-6166
(765) 746-6935
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
01/09/2017
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