Individual
JILLIAN HELENE SAMELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1678 FRY RD STE B, GREENWOOD, IN 46142-1176
(317) 449-8054
Mailing address
8701 N CREEKWOOD CT, MUNCIE, IN 47303-9381
(765) 749-5994
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013421A
IN
122300000X
Dentist
DN1856253
MA
Other
Enumeration date
05/29/2013
Last updated
10/28/2020
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