Provider Demographics
NPI:1588201313
Name:KOKOMO ENDODONTICS INC
Entity Type:Organization
Organization Name:KOKOMO ENDODONTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:ASLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-910-7168
Mailing Address - Street 1:112 E ALTO RD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3601
Mailing Address - Country:US
Mailing Address - Phone:765-455-2505
Mailing Address - Fax:765-455-2564
Practice Address - Street 1:112 E ALTO RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3601
Practice Address - Country:US
Practice Address - Phone:765-455-2505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty