Individual
VLADIMIR KHANTSIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4825 E 96TH ST, 800, INDIANAPOLIS, IN 46240-3800
(317) 818-0800
(317) 818-0880
Mailing address
1550 W 96TH ST, INDIANAPOLIS, IN 46260-4810
(317) 848-2047
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010221
IN
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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