Organization
DENTAL PROFESSIONALS OF IN, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF IN, P.C.
Other names
Park 100 Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF IN, P.C.
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
8570 NORTHWEST BLVD, INDIANAPOLIS, IN 46278-1383
(317) 608-5692
Mailing address
8570 NORTHWEST BLVD, INDIANAPOLIS, IN 46278-1383
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/13/2020
Last updated
12/10/2024
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