Organization
REGION DENTAL GROUP LLC
Active
Other names
Region Dental Group, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
AJMAL S. WARDAK DDS (DENTIST/OWNER)
(317) 225-6666
Entity
Organization
Contact information
Practice address
713 US HIGHWAY 41 STE A, SCHERERVILLE, IN 46375-1798
(219) 227-8694
(219) 266-5894
Mailing address
713 US HIGHWAY 41 STE A, SCHERERVILLE, IN 46375-1798
(219) 227-8694
(219) 266-5894
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588793913
DENTAL
IN
Enumeration date
10/21/2022
Last updated
10/21/2022
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