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Organization

JP DENTAL - RICHMOND LLC

Active
Parent organization
EVOLUTION DENTAL
Other names
Spring Grove Dental
Organization subpart
Yes

Provider details

NPI number
Legal business name
EVOLUTION DENTAL
Authorized official
DR. JOHN PASICZNYK DDS (PRESIDENT)
(317) 818-7777
Entity
Organization

Contact information

Practice address
894 SIM HODGIN PKWY, RICHMOND, IN 47374-1931
(765) 962-3713
Mailing address
894 SIM HODGIN PKWY, RICHMOND, IN 47374-1931
(765) 962-3713

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
06/06/2016
Last updated
06/06/2016
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