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Organization
KLUTH FAMILY DENTISTRY,INC
Active
Organization
KLUTH FAMILY DENTISTRY,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDY LYNN FISHER (PRACTICE ADMINISTRATOR)
(317) 770-1050
Entity
Organization
Contact information
Practice address
16000 PROSPERITY DR STE 400, NOBLESVILLE, IN 46060-4322
(317) 770-1050
(317) 770-1645
Mailing address
16000 PROSPERITY DR STE 400, NOBLESVILLE, IN 46060-4322
(317) 770-1050
(317) 770-1645
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009126
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100173090A
—
IN
Enumeration date
02/27/2017
Last updated
03/21/2017
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