| Madison Ave Dental LLC | |
|
701 N Madison Ave Greenwood IN 46142-4126 | |
| (317) 881-4305 | |
| Not Available |
| Full Name | Madison Ave Dental LLC |
|---|---|
| Speciality | Dentist |
| Location | 701 N Madison Ave, Greenwood, Indiana |
| Authorized Official Name and Position | Kurush Savabi (OWNER) |
| Authorized Official Contact | 3174177486 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Ave Dental LLC 701 N Madison Ave Greenwood IN 46142-4126 Ph: (317) 881-4305 | Madison Ave Dental LLC 701 N Madison Ave Greenwood IN 46142-4126 Ph: (317) 881-4305 |
| NPI Number | 1063993582 |
|---|---|
| Provider Enumeration Date | 08/23/2018 |
| Last Update Date | 12/06/2020 |
| Certification Date | 12/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063993582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12011832A (Indiana) | Primary |
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