Provider Demographics
NPI:1083248223
Name:KOLTE, RASIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RASIKA
Middle Name:
Last Name:KOLTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 BALMORAL WAY APT 7M
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-6306
Mailing Address - Country:US
Mailing Address - Phone:973-590-1972
Mailing Address - Fax:
Practice Address - Street 1:304 NORRIS AVE
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-2343
Practice Address - Country:US
Practice Address - Phone:812-346-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013320A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist