| Kids & Adult Dental Southport Inc | |
|
7001 Madison Ave Southport IN 46227-5203 | |
| (317) 991-4725 | |
| (317) 986-4097 |
| Full Name | Kids & Adult Dental Southport Inc |
|---|---|
| Speciality | Dentist |
| Location | 7001 Madison Ave, Southport, Indiana |
| Authorized Official Name and Position | Brandi Bibb (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 3179914725 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids & Adult Dental Southport Inc 7001 Madison Ave Southport IN 46227-5203 Ph: (317) 991-4725 | Kids & Adult Dental Southport Inc 7001 Madison Ave Southport IN 46227-5203 Ph: (317) 991-4725 |
| NPI Number | 1689553018 |
|---|---|
| Provider Enumeration Date | 08/29/2025 |
| Last Update Date | 12/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689553018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |