# W MICHAEL PRINCELL DDS PC

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

## Provider details

- **NPI number:** 1053459545
- **Authorized official:** MRS. MARTINA G PRINCELL RN (OFFICE ADMIN)
- **Authorized official phone:** (317) 577-2478

## Contact information

- **Practice address:** 7207 N SHADELAND AVE, SUITE A, INDPLS, IN 46250
- **Practice address phone:** (317) 577-2478
- **Practice address fax:** (317) 578-8773
- **Mailing address:** 7207 N SHADELAND AVE, SUITE A, INDPLS, IN 46250
- **Mailing address phone:** (317) 577-2478
- **Mailing address fax:** (317) 578-8773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12009143 | IN | Yes |

## Other

- **Enumeration date:** 02/05/2007
- **Last updated:** 08/22/2020