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General NPI Number Information
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NPI Number | 1164046876
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Entity Type | Organization
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Legal Business Name | TOP DENTAL CARE LLC
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Dates
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Enumeration Date | 05/29/2020
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Last Update Date | 05/29/2020
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Provider Practice Location Address
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Address Line | 41 N. MADISON AVE
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City | GREENWOOD
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State | IN
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Zip | 46142
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Country | US
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Telephone | 317-882-4412
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Fax | 317-882-4413
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Provider Business Mailing Address
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Address Line | 41 N. MADISON AVE
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City | GREENWOOD
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State | IN
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Zip | 46142
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Country | US
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Telephone | 317-882-4412
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Fax | 317-882-4413
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Authorized Official
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Title or Position | MEMBER
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Name | MR. SANTIAGO OCAMPO
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Credential |
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Telephone | 317-882-4412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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