| Washington Street Dentistry | |
|
10935 E Washington St Suite A Indianapolis IN 46229-3181 | |
| (317) 890-4435 | |
| (317) 890-4460 |
| Full Name | Washington Street Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 10935 E Washington St, Indianapolis, Indiana |
| Authorized Official Name and Position | Matthew E Church (OWNER/DENTIST) |
| Authorized Official Contact | 3173366723 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Washington Street Dentistry 10935 E Washington St Suite A Indianapolis IN 46229-3181 Ph: (317) 890-4435 | Washington Street Dentistry 10935 E Washington St Suite A Indianapolis IN 46229-3181 Ph: (317) 890-4435 |
| NPI Number | 1225286099 |
|---|---|
| Provider Enumeration Date | 09/04/2008 |
| Last Update Date | 02/05/2013 |
| Medicare PECOS PAC ID | 8426295452 |
|---|---|
| Medicare Enrollment ID | O20210503001835 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225286099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Matthew E Church |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1033127063 PECOS PAC ID: 9537304936 Enrollment ID: I20210503001935 |
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