# FISHERS FAMILY DENTAL, LLC

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

## Provider details

- **NPI number:** 1366088056
- **Authorized official:** ASHLEY COAD (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (317) 570-5480

## Contact information

- **Practice address:** 9865 E 116TH ST STE 100, FISHERS, IN 46037-9237
- **Practice address phone:** (317) 570-5480
- **Mailing address:** 9865 E 116TH ST STE 100, FISHERS, IN 46037-9237
- **Mailing address phone:** (317) 570-5480

## Taxonomy

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

## Other

- **Enumeration date:** 11/18/2019
- **Last updated:** 11/18/2019