Provider Demographics
NPI:1932595667
Name:DENTAL HEALTH ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DENTAL HEALTH ASSOCIATES, INC.
Other - Org Name:DR. JERROLD GOLDSMITH, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-357-4018
Mailing Address - Street 1:141 N SHORTRIDGE RD
Mailing Address - Street 2:B5
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219
Mailing Address - Country:US
Mailing Address - Phone:317-357-4018
Mailing Address - Fax:317-356-4600
Practice Address - Street 1:141 N SHORTRIDGE RD
Practice Address - Street 2:B5
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-8906
Practice Address - Country:US
Practice Address - Phone:317-357-4018
Practice Address - Fax:317-356-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty