| Louly Dentistry, Inc | |
|
11530 E Washington Street Indianapolis IN 46229-2828 | |
| (317) 869-0000 | |
| (317) 869-0233 |
| Full Name | Louly Dentistry, Inc |
|---|---|
| Speciality | Dentist |
| Location | 11530 E Washington Street, Indianapolis, Indiana |
| Authorized Official Name and Position | Ammar C. Louly (PRESIDENT) |
| Authorized Official Contact | 3178690000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Louly Dentistry, Inc 11530 E Washington Street Indianapolis IN 46229-2828 Ph: (317) 869-0000 | Louly Dentistry, Inc 11530 E Washington Street Indianapolis IN 46229-2828 Ph: (317) 869-0000 |
| NPI Number | 1003104043 |
|---|---|
| Provider Enumeration Date | 07/12/2011 |
| Last Update Date | 05/25/2023 |
| Medicare PECOS PAC ID | 4082882360 |
|---|---|
| Medicare Enrollment ID | O20110713000443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003104043 | NPI | - | NPPES |
| Provider Name | Ammar C Louly |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1699808899 PECOS PAC ID: 1355519539 Enrollment ID: I20110713000464 |
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