Organization
DENTAL PROFESSIONALS OF IN, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF IN, P.C.
Other names
Dental Care at Columbus Crossing
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF IN, P.C.
Authorized official
KELLI ELLSWORTH (CREDENTIALING)
(217) 540-5152
Entity
Organization
Contact information
Practice address
2145 W JONATHAN MOORE PIKE, COLUMBUS, IN 47201-9081
(812) 618-9110
Mailing address
2145 W JONATHAN MOORE PIKE, COLUMBUS, IN 47201-9081
(812) 618-9110
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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