# INDY DENTAL GROUP WEST 86TH, INC.

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

## Provider details

- **NPI number:** 1477913499
- **Authorized official:** DR. ELIZABETH B LEWIS DDS (OWNER)
- **Authorized official phone:** (317) 571-1900

## Contact information

- **Practice address:** 3711 W 86TH ST, INDIANAPOLIS, IN 46268-1904
- **Practice address phone:** (317) 571-1900
- **Practice address fax:** (317) 569-9695
- **Mailing address:** 3711 W 86TH ST, INDIANAPOLIS, IN 46268-1904
- **Mailing address phone:** (317) 571-1900
- **Mailing address fax:** (317) 569-9695

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009479A | IN | Yes |

## Other

- **Enumeration date:** 03/03/2016
- **Last updated:** 03/03/2016