# RIDER FAMILY DENTISTRY LLC

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

## Provider details

- **NPI number:** 1053093351
- **Authorized official:** KURTIS RIDER DMD (MANAGER)
- **Authorized official phone:** (317) 201-3576

## Contact information

- **Practice address:** 1305 W 86TH ST, INDIANAPOLIS, IN 46260-2481
- **Practice address phone:** (317) 259-1501
- **Mailing address:** 15884 VIKING LAIR RD, WESTFIELD, IN 46074-5526

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 08/04/2023
- **Last updated:** 08/04/2023