Organization
ADVANCED DENTAL CARE OF ANDERSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK SUMMERLIN III DDS (OWNER)
(317) 409-8819
Entity
Organization
Contact information
Practice address
1612 E 53RD ST, ANDERSON, IN 46013-2826
(765) 622-7000
Mailing address
11333 MIRADOR LN, FISHERS, IN 46037-8687
(317) 409-8819
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
07/09/2019
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