# SALAZAR DENTAL OF INDIANA INC

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

## Provider details

- **NPI number:** 1497569347
- **Authorized official:** MARTIN R SALAZAR (DOCTOR)
- **Authorized official phone:** (317) 636-2002

## Contact information

- **Practice address:** 2015 W WASHINGTON ST STE B2, INDIANAPOLIS, IN 46222-4652
- **Practice address phone:** (317) 636-2002
- **Practice address fax:** (317) 803-3327
- **Mailing address:** 2015 W WASHINGTON ST STE B2, INDIANAPOLIS, IN 46222-4652
- **Mailing address phone:** (317) 636-2002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 02/03/2025
- **Last updated:** 02/03/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1588729164 | — | IN |