# EZ DENTAL AND DENTURES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003066028
- **Authorized official:** MR. TOM DOOLEY (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (317) 566-3300

## Contact information

- **Practice address:** 14904 GREYHOUND CT, CARMEL, IN 46032-1091
- **Practice address phone:** (317) 566-3300
- **Practice address fax:** (317) 566-3302
- **Mailing address:** 14904 GREYHOUND CT, CARMEL, IN 46032-1091
- **Mailing address phone:** (317) 566-3300
- **Mailing address fax:** (317) 566-3302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009121A | IN | Yes |

## Other

- **Enumeration date:** 09/26/2008
- **Last updated:** 09/26/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200903800A | — | IN |