# INDIANA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Indiana Oral and Maxillofacial Surgery Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407809585
- **Authorized official:** KEITH MILLER (ADMINISTRATOR)
- **Authorized official phone:** (317) 913-2363

## Contact information

- **Practice address:** 10972 ALLISONVILLE RD, SUITE 110, FISHERS, IN 46038-2637
- **Practice address phone:** (317) 913-2363
- **Practice address fax:** (317) 913-2370
- **Mailing address:** 10972 ALLISONVILLE RD, SUITE 110, FISHERS, IN 46038-2637
- **Mailing address phone:** (317) 913-2363
- **Mailing address fax:** (317) 913-2370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 03/13/2026