| Woodside Dental Center Llc | |
|
1523 State St New Albany IN 47150-4911 | |
| (812) 944-9929 | |
| Not Available |
| Full Name | Woodside Dental Center Llc |
|---|---|
| Speciality | Dentist |
| Location | 1523 State St, New Albany, Indiana |
| Authorized Official Name and Position | Maurice Chris Zaepfel (OWNER) |
| Authorized Official Contact | 8129449929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodside Dental Center Llc 1523 State St New Albany IN 47150-4911 Ph: (812) 944-9929 | Woodside Dental Center Llc 1523 State St New Albany IN 47150-4911 Ph: (812) 944-9929 |
| NPI Number | 1598923120 |
|---|---|
| Provider Enumeration Date | 05/30/2008 |
| Last Update Date | 05/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598923120 | NPI | - | NPPES |
| 200433910 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12010015A (Indiana) | Primary |
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