MEDICARE: MILAN SHETH D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12012485A	IN

General Provider Information

NPI Number	:	1174970230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILAN SHETH D.D.S.

Provider Business Mailing Address
First Line	:	3206 EL LAGO NORTH DR
Second Line	:	APT B
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-4022
Country	:	US
Telephone Number	:	219-487-1164
Fax Number	:

Provider Business Practice Location Address
First Line	:	4350 N FRANKLIN RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46226-4002
Country	:	US
Telephone Number	:	317-546-5305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	05/18/2016

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Directions to “ MILAN SHETH D.D.S.” Practice Location

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