# TLC FAMILY DENTISTRY, LLC

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

## Provider details

- **NPI number:** 1184380552
- **Authorized official:** TANNER CRANDELL DDS (DENTIST / OWNER)
- **Authorized official phone:** (260) 515-3217

## Contact information

- **Practice address:** 7625 S MERIDIAN ST, INDIANAPOLIS, IN 46217-4257
- **Practice address phone:** (317) 881-8271
- **Mailing address:** 7625 S MERIDIAN ST, INDIANAPOLIS, IN 46217-4257

## Taxonomy

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

## Other

- **Enumeration date:** 11/10/2021
- **Last updated:** 11/10/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 12009264A | IN DENTAL LICENSE | IN |
| 01 | — | 12013136A | IN DENTAL LICENSE | IN |
| 01 | — | 1689662298 | NPI TYPE 1 | IN |
| 01 | — | 1730746710 | NPI TYPE 1 | IN |