| Immediadent | |
|
360 New Albany Plz New Albany IN 47150-4654 | |
| (812) 945-4040 | |
| (913) 800-6967 |
| Full Name | Immediadent |
|---|---|
| Speciality | Dentist |
| Location | 360 New Albany Plz, New Albany, Indiana |
| Authorized Official Name and Position | Thomas Frank (PC PRESIDENT) |
| Authorized Official Contact | 8122846328 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Immediadent Po Box 11568 Overland Park KS 66207-4268 Ph: (913) 800-6952 | Immediadent 360 New Albany Plz New Albany IN 47150-4654 Ph: (812) 945-4040 |
| NPI Number | 1124496005 |
|---|---|
| Provider Enumeration Date | 09/09/2015 |
| Last Update Date | 09/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124496005 | NPI | - | NPPES |
| 200377170 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12010746A (Indiana) | Primary |
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