# VILLAGE DENTAL, PC

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

## Provider details

- **NPI number:** 1043618457
- **Authorized official:** MRS. CHRISTINA HUBBARD (DISTRICT MANAGER)
- **Authorized official phone:** (317) 773-5833

## Contact information

- **Practice address:** 13578 E 131ST ST, FISHERS, IN 46037-6400
- **Practice address phone:** (317) 773-5833
- **Practice address fax:** (317) 773-5991
- **Mailing address:** 13578 E 131ST ST, FISHERS, IN 46037-6400
- **Mailing address phone:** (317) 773-5833
- **Mailing address fax:** (317) 773-5991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | — |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 12/17/2014
- **Last updated:** 12/17/2014