| Park Pediatric Dentistry Llc | |
|
1700 W Smith Valley Rd Suite B1 Greenwood IN 46142-1599 | |
| (317) 627-1755 | |
| Not Available |
| Full Name | Park Pediatric Dentistry Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1700 W Smith Valley Rd, Greenwood, Indiana |
| Authorized Official Name and Position | Lesa Allison (OWNER, MANAGING MEMBER) |
| Authorized Official Contact | 3176271755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Pediatric Dentistry Llc Po Box 441143 Indianapolis IN 46244-1143 Ph: () - | Park Pediatric Dentistry Llc 1700 W Smith Valley Rd Suite B1 Greenwood IN 46142-1599 Ph: (317) 627-1755 |
| NPI Number | 1730610833 |
|---|---|
| Provider Enumeration Date | 03/21/2017 |
| Last Update Date | 03/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730610833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 12011836A (Indiana) | Primary |
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