| Shank Center For Dentistry Llc | |
|
6904 S East St Suite F Indianapolis IN 46227-2693 | |
| (317) 788-4239 | |
| Not Available |
| Full Name | Shank Center For Dentistry Llc |
|---|---|
| Speciality | Dentist |
| Location | 6904 S East St, Indianapolis, Indiana |
| Authorized Official Name and Position | Kyle Wesley Shank (SOLE MEMBER) |
| Authorized Official Contact | 3177884239 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shank Center For Dentistry Llc 6904 S East St Suite F Indianapolis IN 46227-2693 Ph: (317) 788-4239 | Shank Center For Dentistry Llc 6904 S East St Suite F Indianapolis IN 46227-2693 Ph: (317) 788-4239 |
| NPI Number | 1548565831 |
|---|---|
| Provider Enumeration Date | 01/18/2011 |
| Last Update Date | 01/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548565831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1201391A (Indiana) | Primary |
| 1223G0001X | Dentist - General Practice | 1201391A (Indiana) | Secondary |
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