# DENTAL PROFESSIONALS OF INDIANA, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DENTAL PROFESSIONALS OF INDIANA, P.C.
- **Other names:** Promenade Dental Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1376415273
- **Legal business name:** DENTAL PROFESSIONALS OF INDIANA, P.C.
- **Authorized official:** CEMYIRA MCDOUGAL (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (217) 764-8609

## Contact information

- **Practice address:** 5957 PROMENADE SHOPS BLVD STE 105, NOBLESVILLE, IN 46062-5620
- **Practice address phone:** (317) 900-4940
- **Mailing address:** 5957 PROMENADE SHOPS BLVD STE 105, NOBLESVILLE, IN 46062-5620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 09/19/2025
- **Last updated:** 09/19/2025