| |
642 E Main St Brownsburg IN 46112-1423 | |
(317) 771-9244 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 642 E Main St, Brownsburg, Indiana |
Authorized Official Name and Position | Ashwani Sharma (OWNER) |
Authorized Official Contact | 3177719244 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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653 Ridge Gate Dr Brownsburg IN 46112-7801 Ph: (317) 771-9244 | 642 E Main St Brownsburg IN 46112-1423 Ph: (317) 771-9244 |
NPI Number | 1770054520 |
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Provider Enumeration Date | 12/05/2018 |
Last Update Date | 03/17/2021 |
Medicare PECOS PAC ID | 4385051341 |
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Medicare Enrollment ID | O20210318002789 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770054520 | NPI | - | NPPES |
201259950 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Provider Name | Ashwani Sharma |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1639465149 PECOS PAC ID: 3577865401 Enrollment ID: I20210318002455 |
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