Individual
DR. GARY LEE LLEWELLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6211 W 30TH ST, SUITE G, INDIANAPOLIS, IN 46224-3048
(317) 291-7550
(317) 291-1746
Mailing address
6211 W 30TH ST, SUITE G, INDIANAPOLIS, IN 46224-3048
(317) 291-7550
(317) 291-1746
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008920
IN
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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