Advanced Dental Care of Anderson LLC

Organization Active NPI General Practice Dentistry · Anderson, IN

NPI 1689088601 · NPPES record last updated Jun 18, 2014

Key facts

NPI
1689088601
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
12010047A (IN)
Legal business name
ADVANCED DENTAL CARE OF ANDERSON LLC
Practice address
1612 E 53Rd St
Anderson, IN 46013-2826
Phone
(765) 622-7000
Fax
(765) 622-9642
NPI assigned
Jun 18, 2014
Organization subpart
No

Authorized official

Name
Dr. James Patrick Elbrecht, DDS
Title
Dentist
Phone
(765) 622-7000

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 12010047A IN Yes

Addresses

Primary practice location

1612 E 53Rd St
Anderson, IN 46013-2826

Mailing address

1612 E 53Rd St
Anderson, IN 46013-2826
Phone (765) 622-7000

Other identifiers

IdentifierTypeStateIssuer
200283200MedicaidIN

Other providers in Anderson, IN

All providers in Anderson, IN · General Practice Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.