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Organization
MFDC OF INDIANA, INC
Active
Organization
MFDC OF INDIANA, INC
Active
Other names
Georgetown Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PARDUE (DIRECTOR OF REVENUE CYCLE)
(502) 548-2402
Entity
Organization
Contact information
Practice address
5525 GEORGETOWN RD STE B, INDIANAPOLIS, IN 46254-3717
(502) 254-8500
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
(502) 254-8500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
Other
Enumeration date
01/15/2025
Last updated
02/10/2025
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