|
| |
|
604 E Boulevard Suite B Kokomo IN 46902-2200 | |
| (765) 864-2328 | |
| (765) 864-2333 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 604 E Boulevard, Kokomo, Indiana |
| Authorized Official Name and Position | Scott B Boltz (OWNER) |
| Authorized Official Contact | 7658642328 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
604 E Boulevard Suite B Kokomo IN 46902-2200 Ph: (765) 864-2328 | 604 E Boulevard Suite B Kokomo IN 46902-2200 Ph: (765) 864-2328 |
| NPI Number | 1063658631 |
|---|---|
| Provider Enumeration Date | 01/01/2009 |
| Last Update Date | 01/01/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063658631 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 12008297A (Indiana) | Primary |
Kokomo Pediatric Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2350 S Dixon Rd Ste 425, Kokomo, IN 46902 Phone: 765-453-6000 | |
Howard County Oral And Maxillofacial Surgeons Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1970 W Boulevard, Kokomo, IN 46902 Phone: 765-868-2222 Fax: 765-868-8119 | |
Family And Cosmetic Dentistry Of Kokomo, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5111 Clinton Dr, Kokomo, IN 46902 Phone: 765-453-4369 |