Individual
DR. KIM E DIEFENDERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS, MS
Contact information
Practice address
1121 W MICHIGAN ST, INDIANAPOLIS, IN 46202-5211
(172) 743-7153
Mailing address
2728 STILL CREEK DR, ZIONSVILLE, IN 46077-1195
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12012261A
IN
1223G0001X
General Practice Dentistry
Primary
DS027331L
PA
Other
Enumeration date
02/08/2006
Last updated
11/08/2021
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