| Aspen Dental Group, Pc | |
|
3725 Rome Dr Ste A Lafayette IN 47905-4490 | |
| (765) 447-2725 | |
| (765) 449-2373 |
| Full Name | Aspen Dental Group, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3725 Rome Dr Ste A, Lafayette, Indiana |
| Authorized Official Name and Position | Heath W. Jones (OWNER / DENTIST) |
| Authorized Official Contact | 7654472725 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Dental Group, Pc 3725 Rome Dr Ste A Lafayette IN 47905-4490 Ph: (765) 447-2725 | Aspen Dental Group, Pc 3725 Rome Dr Ste A Lafayette IN 47905-4490 Ph: (765) 447-2725 |
| NPI Number | 1003902784 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 02/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003902784 | NPI | - | NPPES |
| 200428580 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | 12009872A (Indiana) | Primary |
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