Individual
DR. SAMUEL ALAN PASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7131 MOHAWK LANE, INDIANAPOLIS, IN 46260
(502) 767-0027
(270) 798-8633
Mailing address
7131 MOHAWK LANE, INDIANAPOLIS, IN 46260
(502) 767-0027
(270) 798-8633
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
019-020471
IL
1223P0300X
Periodontics
040718
NY
1223P0300X
Periodontics
Primary
12008878
IN
1223P0300X
Periodontics
2901012290
MI
1223P0300X
Periodontics
5321
NE
1223P0300X
Periodontics
DS020240L
PA
Other
Enumeration date
02/14/2006
Last updated
07/10/2013
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