| Spark Dental In, Llc | |
|
9602 E Washington St Ste B Indianapolis IN 46229-3060 | |
| (317) 898-7645 | |
| Not Available |
| Full Name | Spark Dental In, Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 9602 E Washington St Ste B, Indianapolis, Indiana |
| Authorized Official Name and Position | Phi Le (CREDENTIALING MANAER) |
| Authorized Official Contact | 2675752321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spark Dental In, Llc 300 Willowbrook Ln Ste 330 West Chester PA 19382-5594 Ph: (267) 575-2321 | Spark Dental In, Llc 9602 E Washington St Ste B Indianapolis IN 46229-3060 Ph: (317) 898-7645 |
| NPI Number | 1679282743 |
|---|---|
| Provider Enumeration Date | 11/17/2022 |
| Last Update Date | 11/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679282743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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