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Organization

DENTAL HEALTH ASSOCIATES OF INDIANA

Active
Other names
Avon Gentle Dentlst
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIM HOAGLAND (EXECUTIVE)
(502) 423-9111
Entity
Organization

Contact information

Practice address
8101 E US HIGHWAY 36 STE A, AVON, IN 46123-8082
(317) 272-6990
(317) 272-6994
Mailing address
12802 TOWNEPARK WAY, SUITE 100, LOUISVILLE, KY 40243-2394
(502) 423-9111

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1223P0221X
Pediatric Dentistry
Primary
12012042
IN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry

Other

Enumeration date
11/08/2006
Last updated
10/10/2016
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