# MOUCHAHAM DENTISTRY, LLC

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

## Provider details

- **NPI number:** 1326860099
- **Authorized official:** DR. NICHOLAS MOUCHAHAM DMD (OWNER/DENTIST)
- **Authorized official phone:** (765) 729-2236

## Contact information

- **Practice address:** 5790 E MAIN ST STE 110, CARMEL, IN 46033-6200
- **Practice address phone:** (317) 844-2810
- **Mailing address:** 14707 KELLER TER, CARMEL, IN 46033-8887
- **Mailing address phone:** (765) 729-2236

## Taxonomy

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

## Other

- **Enumeration date:** 10/24/2024
- **Last updated:** 10/27/2024