| Lakewood Family Dental Of Kokomo Pllc | |
|
2302 S Dixon Rd Ste 125 Kokomo IN 46902-6429 | |
| (732) 379-0953 | |
| Not Available |
| Full Name | Lakewood Family Dental Of Kokomo Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2302 S Dixon Rd Ste 125, Kokomo, Indiana |
| Authorized Official Name and Position | Srinivasulu Kakollu (PRESIDENT) |
| Authorized Official Contact | 7323790953 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Family Dental Of Kokomo Pllc 8777 Purdue Rd Ste 115 Indianapolis IN 46268-3104 Ph: () - | Lakewood Family Dental Of Kokomo Pllc 2302 S Dixon Rd Ste 125 Kokomo IN 46902-6429 Ph: (732) 379-0953 |
| NPI Number | 1346738556 |
|---|---|
| Provider Enumeration Date | 04/24/2018 |
| Last Update Date | 04/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346738556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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