Individual
KASIE Y NAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6117 N COLLEGE AVE STE 1, INDIANAPOLIS, IN 46220-1952
(317) 256-3368
(317) 257-5909
Mailing address
6117 N COLLEGE AVE STE 1, INDIANAPOLIS, IN 46220-1952
(317) 256-3368
(317) 257-5909
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010943A
IN
Other
Enumeration date
10/05/2006
Last updated
01/18/2017
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