| Indy Dental Group West 86th, Inc. | |
|
3711 W 86th St Indianapolis IN 46268-1904 | |
| (317) 571-1900 | |
| (317) 569-9695 |
| Full Name | Indy Dental Group West 86th, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3711 W 86th St, Indianapolis, Indiana |
| Authorized Official Name and Position | Elizabeth B Lewis (OWNER) |
| Authorized Official Contact | 3175711900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indy Dental Group West 86th, Inc. 3711 W 86th St Indianapolis IN 46268-1904 Ph: (317) 571-1900 | Indy Dental Group West 86th, Inc. 3711 W 86th St Indianapolis IN 46268-1904 Ph: (317) 571-1900 |
| NPI Number | 1477913499 |
|---|---|
| Provider Enumeration Date | 03/03/2016 |
| Last Update Date | 03/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477913499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12009479A (Indiana) | Primary |
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