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Organization
CENTRAL INDIANA PERIODONTAL ASSOCIATES,LLC
Active
Organization
CENTRAL INDIANA PERIODONTAL ASSOCIATES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL GOMES DDS, MSD (REGISTERED AGENT)
(317) 299-4731
Entity
Organization
Contact information
Practice address
2840 N HIGH SCHOOL RD, INDIANAPOLIS, IN 46224-4724
(317) 299-4731
(317) 329-5054
Mailing address
2840 N HIGH SCHOOL RD, INDIANAPOLIS, IN 46224-4724
(317) 299-4731
(317) 329-5054
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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