# MITTHOEFFER FAMILY DENTAL, LLC

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

## Provider details

- **NPI number:** 1154879856
- **Authorized official:** LANA HURLEY (PRACTICE DIRECTOR)
- **Authorized official phone:** (317) 926-5467

## Contact information

- **Practice address:** 2236 N MITTHOEFFER RD, INDIANAPOLIS, IN 46229-1797
- **Practice address phone:** (317) 897-5093
- **Mailing address:** 2236 N MITTHOEFFER RD, INDIANAPOLIS, IN 46229-1797
- **Mailing address phone:** (317) 897-5093

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2016
- **Last updated:** 09/12/2016