| Glendale Dental Associates Pc Ii | |
|
6202 Evanston Ave Indianapolis IN 46220-2100 | |
| (317) 251-0085 | |
| (317) 259-9084 |
| Full Name | Glendale Dental Associates Pc Ii |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6202 Evanston Ave, Indianapolis, Indiana |
| Authorized Official Name and Position | John Cho (OWNER/DENTIST) |
| Authorized Official Contact | 3172510085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glendale Dental Associates Pc Ii 6202 Evanston Ave Indianapolis IN 46220-2100 Ph: (317) 251-0085 | Glendale Dental Associates Pc Ii 6202 Evanston Ave Indianapolis IN 46220-2100 Ph: (317) 251-0085 |
| NPI Number | 1528246618 |
|---|---|
| Provider Enumeration Date | 01/31/2008 |
| Last Update Date | 12/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528246618 | NPI | - | NPPES |
| 12010540A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12010539A (Indiana) | Primary |
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