NPI 1912139841

Bacsa Dental PC

Organisation Preferred Provider Organization Indianapolis, IN

Practice location

Address: 4625 S Emerson Ave, Indianapolis, IN 46203-5972
Phone: (317) 784-5555
Mailing address: 8805 Knotty Pine CT, Indianapolis, IN 46227-9764

Authorised official

Name: Timothy Bacsa
Title: President
Phone: (317) 258-0309

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 12010741A (IN)

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Registry record

NPI: 1912139841
Entity type: Organization
NPI issued: 11 Aug 2009
Record last updated: 11 Aug 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.