| Advanced Dentistry & Tmj | |
|
14753 Hazel Dell Xing Suite 700 Noblesville IN 46062-7025 | |
| (317) 208-0000 | |
| (317) 208-4704 |
| Full Name | Advanced Dentistry & Tmj |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 14753 Hazel Dell Xing, Noblesville, Indiana |
| Authorized Official Name and Position | Mike Hashem Deldar (OWNER) |
| Authorized Official Contact | 3172080000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dentistry & Tmj 14753 Hazel Dell Xing Suite 700 Noblesville IN 46062-7025 Ph: (317) 208-0000 | Advanced Dentistry & Tmj 14753 Hazel Dell Xing Suite 700 Noblesville IN 46062-7025 Ph: (317) 208-0000 |
| NPI Number | 1326342841 |
|---|---|
| Provider Enumeration Date | 12/23/2010 |
| Last Update Date | 03/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326342841 | NPI | - | NPPES |
| 200204900B | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12009956A (Indiana) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 12009956A (Indiana) | Primary |
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