| West 38th Dental, Ltd | |
|
3808 N Lawndale Ave Indianapolis IN 46254-2814 | |
| (317) 297-4502 | |
| (317) 297-4554 |
| Full Name | West 38th Dental, Ltd |
|---|---|
| Speciality | Dentist |
| Location | 3808 N Lawndale Ave, Indianapolis, Indiana |
| Authorized Official Name and Position | Sung H Kong (OWNER) |
| Authorized Official Contact | 3172974502 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West 38th Dental, Ltd 3808 N Lawndale Ave Indianapolis IN 46254-2814 Ph: (317) 297-4502 | West 38th Dental, Ltd 3808 N Lawndale Ave Indianapolis IN 46254-2814 Ph: (317) 297-4502 |
| NPI Number | 1245649052 |
|---|---|
| Provider Enumeration Date | 08/06/2014 |
| Last Update Date | 08/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245649052 | NPI | - | NPPES |
| 200533220A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12010747A (Indiana) | Primary |
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