Organization
LAKEWOOD FAMILY DENTAL OF CARMEL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRINIVASULU KAKOLLU (DENTIST)
(732) 379-0953
Entity
Organization
Contact information
Practice address
2330 E 116TH ST, CARMEL, IN 46032-3217
(317) 456-7869
Mailing address
8777 PURDUE RD STE 115, INDIANAPOLIS, IN 46268-3104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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