| College Park Oral & Maxillofacial Surgery | |
|
3677 W 86th Street Indianapolis IN 46268-1902 | |
| (317) 872-7777 | |
| (317) 872-3174 |
| Full Name | College Park Oral & Maxillofacial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3677 W 86th Street, Indianapolis, Indiana |
| Authorized Official Name and Position | J Harold Smith (PRESIDENT) |
| Authorized Official Contact | 3178727777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| College Park Oral & Maxillofacial Surgery 3677 W 86th Street Indianapolis IN 56268-1902 Ph: (317) 872-7777 | College Park Oral & Maxillofacial Surgery 3677 W 86th Street Indianapolis IN 46268-1902 Ph: (317) 872-7777 |
| NPI Number | 1043309719 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043309719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (Indiana) | Primary |
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