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NPI Code Detail

MEDICARE: COLUMBUS DENTAL CORP

MEDICARE: COLUMBUS DENTAL CORP
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1487293403
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLUMBUS DENTAL CORP
Provider Business Mailing Address
First Line : 360 E MARKET ST APT 2002
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46204-2961
Country : US
Telephone Number : 317-525-7398
Fax Number :
Provider Business Practice Location Address
First Line : 1641 N NATIONAL RD
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-5579
Country : US
Telephone Number : 812-799-0690
Fax Number : 812-657-7877
Authorized Official
Title or Position : OWNER
Name : ANKIT PATEL
Credential : DMD
Telephone Number : 317-525-7398
Provider Enumeration Date : 12/23/2019
Last Update Date : 12/23/2019

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Directions to “COLUMBUS DENTAL CORP ” Practice Location

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