Organization
SPARK DENTAL IN, LLC
Active
Organization
SPARK DENTAL IN, LLC
Active
Other names
Werner Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
PHI LE (CREDENTIALING MANAER)
(267) 575-2321
Entity
Organization
Contact information
Practice address
9602 E WASHINGTON ST STE B, INDIANAPOLIS, IN 46229-3060
(317) 898-7645
Mailing address
300 WILLOWBROOK LN STE 330, WEST CHESTER, PA 19382-5594
(267) 575-2321
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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