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Oral Surgery, Dental Specialists

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86TH STREET COMPLETE DENTAL LLC

Dental Care Facilities

Indianapolis, Indiana

Provider NPI: 1194247940

Organization Information:
Organization Name:  86TH STREET COMPLETE DENTAL LLC
Organization is not Subpart
Authorized Official:  MONA P SINGH  OWNER  317-8832727

Practice Location:
3810 W 86TH ST  INDIANAPOLIS, IN 46268 US
Tel: 317-707-6453  Fax: --

Business Mailing Address:
3810 W 86TH ST  INDIANAPOLIS, IN 46268 US
Tel: 317-883-2727  Fax: --

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QD0000XAmbulatory Health Care Facilities
Clinic/Center
Dental

Other Provider Identifiers:

IssuerNumberStateType
NPI162942782801
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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