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NPI Code Detail

MEDICARE: DENTAL HEALTH ASSOCIATES, INC.

MEDICARE: DENTAL HEALTH ASSOCIATES, INC.
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
1122300000XDentist

General Provider Information

NPI Number : 1932595667
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL HEALTH ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 141 N SHORTRIDGE RD
Second Line : B5
City : INDIANAPOLIS
State : IN
Zip : 46219
Country : US
Telephone Number : 317-357-4018
Fax Number : 317-356-4600
Provider Business Practice Location Address
First Line : 141 N SHORTRIDGE RD
Second Line : B5
City : INDIANAPOLIS
State : IN
Zip : 46219-8906
Country : US
Telephone Number : 317-357-4018
Fax Number : 317-356-4600
Authorized Official
Title or Position : MANAGER
Name : ADAM GOLDSMITH
Credential :
Telephone Number : 317-357-4018
Provider Enumeration Date : 04/09/2015
Last Update Date : 04/09/2015

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