Individual
THANKAM PAUL THYVALIKAKATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, PHD
Contact information
Practice address
1121 W MICHIGAN ST, DS285, INDIANAPOLIS, IN 46202-5186
(317) 274-5628
(317) 274-2603
Mailing address
1121 W MICHIGAN ST, DS307B, INDIANAPOLIS, IN 46202-5186
(317) 278-3632
(317) 274-2603
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS038528
PA
Other
Enumeration date
09/20/2012
Last updated
10/11/2016
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