MEDICARE: DR. QUANG L TON DDS

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	12013592A	IN

General Provider Information

NPI Number	:	1194399865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUANG L TON DDS

Provider Business Mailing Address
First Line	:	1854 CASCADES DR
Second Line	:
City	:	GREENFIELD
State	:	IN
Zip	:	46140-5005
Country	:	US
Telephone Number	:	214-909-4185
Fax Number	:

Provider Business Practice Location Address
First Line	:	986 N MITTHOEFER RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2622
Country	:	US
Telephone Number	:	317-899-3106
Fax Number	:	317-899-3141

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

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	02/12/2024

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