| Monrovia Dental Clinic, Llc | |
|
253 W Main St Monrovia IN 46157-9567 | |
| (317) 996-3391 | |
| Not Available |
| Full Name | Monrovia Dental Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 253 W Main St, Monrovia, Indiana |
| Authorized Official Name and Position | Mark Sanford (MEMBER) |
| Authorized Official Contact | 3179963391 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Monrovia Dental Clinic, Llc 253 W Main St Monrovia IN 46157-9567 Ph: () - | Monrovia Dental Clinic, Llc 253 W Main St Monrovia IN 46157-9567 Ph: (317) 996-3391 |
| NPI Number | 1134401144 |
|---|---|
| Provider Enumeration Date | 09/15/2011 |
| Last Update Date | 09/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134401144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 12011298A (Indiana) | Primary |