Individual
DR. MARK VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
55 S STATE AVE, INDIANAPOLIS, IN 46201-3802
(317) 412-2170
Mailing address
10460 AFFIRMED CT, INDIANAPOLIS, IN 46234-7635
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012703A
IN
Other
Enumeration date
06/10/2017
Last updated
06/10/2017
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