# GEBRU DENTAL, LLC

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

## Provider details

- **NPI number:** 1184510323
- **Authorized official:** CHRISTINE BARBER (PROVIDER ENROLLMENT MANAGER)
- **Authorized official phone:** (315) 454-6000

## Contact information

- **Practice address:** 10110 E WASHINGTON ST STE E, INDIANAPOLIS, IN 46229-2638
- **Practice address phone:** (317) 897-0200
- **Mailing address:** PO BOX 70887, CLEVELAND, OH 44190-0887
- **Mailing address phone:** (315) 454-6000

## Taxonomy

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

## Other

- **Enumeration date:** 06/16/2025
- **Last updated:** 06/16/2025