# MS VIBBERT DDS PC

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

## Provider details

- **NPI number:** 1134720147
- **Authorized official:** AMADNA V (OM)
- **Authorized official phone:** (131) 780-2064

## Contact information

- **Practice address:** 7301 GEORGETOWN RD STE 113, INDIANAPOLIS, IN 46268-4157
- **Practice address phone:** (317) 802-0649
- **Mailing address:** 7301 GEORGETOWN RD STE 113, INDIANAPOLIS, IN 46268-4157

## Taxonomy

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

## Other

- **Enumeration date:** 11/05/2020
- **Last updated:** 11/05/2020