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Organization
WTDG SPECIALTY GROUP LLC
Active
Organization
WTDG SPECIALTY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT J BARTA DDS (MEMBER)
(317) 679-8506
Entity
Organization
Contact information
Practice address
6443 W 10TH ST STE 204, INDIANAPOLIS, IN 46214-6502
(317) 247-9512
Mailing address
6443 W 10TH ST STE 204, INDIANAPOLIS, IN 46214-6502
(317) 247-9512
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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