| Gregg C Mazonas Dds Pc | |
|
1818 N Riley Hwy Shelbyville IN 46176-0070 | |
| (317) 392-3231 | |
| (317) 392-3233 |
| Full Name | Gregg C Mazonas Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1818 N Riley Hwy, Shelbyville, Indiana |
| Authorized Official Name and Position | Gregg C Mazonas (PRESIDENT) |
| Authorized Official Contact | 3173923231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregg C Mazonas Dds Pc Po Bx 70 2158 Intelliplex Dr Shelbyville IN 46176-0070 Ph: (317) 392-3231 | Gregg C Mazonas Dds Pc 1818 N Riley Hwy Shelbyville IN 46176-0070 Ph: (317) 392-3231 |
| NPI Number | 1518054428 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 08/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518054428 | NPI | - | NPPES |
| 200244850A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12008860A (Indiana) | Primary |
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