| West Side Llc | |
|
3412 Klondike Rd West Lafayette Bra IN 47906-5218 | |
| (765) 463-6726 | |
| Not Available |
| Full Name | West Side Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3412 Klondike Rd, West Lafayette Bra, Indiana |
| Authorized Official Name and Position | John Piperis James (PRESIDENT) |
| Authorized Official Contact | 7654636726 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Side Llc 3412 Klondike Rd West Lafayette Bra IN 47906-5218 Ph: (765) 463-6726 | West Side Llc 3412 Klondike Rd West Lafayette Bra IN 47906-5218 Ph: (765) 463-6726 |
| NPI Number | 1003928789 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003928789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12009311 (Indiana) | Primary |