Organization
FOUNTAIN SQUARE WESTEND DENTAL LLC
Active
Other names
Westend Dental
Organization subpart
No
Provider details
NPI number
Authorized official
POOJA MANDALIA DDS (OWNER)
(734) 369-7371
Entity
Organization
Contact information
Practice address
1535 PROSPECT ST, INDIANAPOLIS, IN 46203-2053
(734) 369-7375
Mailing address
583 WINDBOROUGH, BROWNSBURG, IN 46112-9341
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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