# FALL CREEK DENTISTRY, PC

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

## Provider details

- **NPI number:** 1356361679
- **Authorized official:** VALERIE EDLEY (OFFICE MANAGER)
- **Authorized official phone:** (317) 596-8000

## Contact information

- **Practice address:** 10106 BROOKS SCHOOL RD, SUITE 500, FISHERS, IN 46037-9804
- **Practice address phone:** (317) 596-8000
- **Practice address fax:** (317) 596-0671
- **Mailing address:** 10106 BROOKS SCHOOL RD, SUITE 500, FISHERS, IN 46037-9804
- **Mailing address phone:** (317) 596-8000
- **Mailing address fax:** (317) 596-0671

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010202 | IN | Yes |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00720339 | UNITED CONCORDIA | IN |