| Hoosier Dentures & Dental Surgery, Llc | |
|
1200 S Peru St Cicero IN 46034-9161 | |
| (317) 809-7790 | |
| Not Available |
| Full Name | Hoosier Dentures & Dental Surgery, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1200 S Peru St, Cicero, Indiana |
| Authorized Official Name and Position | Scott Thole (OWNER) |
| Authorized Official Contact | 3178097790 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hoosier Dentures & Dental Surgery, Llc 1200 S Peru St Cicero IN 46034-9161 Ph: (317) 809-7790 | Hoosier Dentures & Dental Surgery, Llc 1200 S Peru St Cicero IN 46034-9161 Ph: (317) 809-7790 |
| NPI Number | 1609002724 |
|---|---|
| Provider Enumeration Date | 06/03/2009 |
| Last Update Date | 06/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609002724 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 12010014 (Indiana) | Primary |
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