| Castleton General & Implant Dentistry Pc | |
|
6535 E 82nd St Suite 211 Indianapolis IN 46250-4524 | |
| (317) 849-3597 | |
| (317) 913-0641 |
| Full Name | Castleton General & Implant Dentistry Pc |
|---|---|
| Speciality | Dentist |
| Location | 6535 E 82nd St, Indianapolis, Indiana |
| Authorized Official Name and Position | Lucas B Marrs (OWNER) |
| Authorized Official Contact | 3178493597 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Castleton General & Implant Dentistry Pc 6535 E 82nd St Suite 211 Indianapolis IN 46250-4524 Ph: (317) 849-3597 | Castleton General & Implant Dentistry Pc 6535 E 82nd St Suite 211 Indianapolis IN 46250-4524 Ph: (317) 849-3597 |
| NPI Number | 1013166941 |
|---|---|
| Provider Enumeration Date | 09/16/2008 |
| Last Update Date | 01/09/2020 |
| Medicare PECOS PAC ID | 9032544879 |
|---|---|
| Medicare Enrollment ID | O20200124000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013166941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12011157A (Indiana) | Primary |
| Provider Name | Lucas B Marrs |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1871755819 PECOS PAC ID: 5496050973 Enrollment ID: I20200124000983 |
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