# MFDC OF INDIANA, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Georgetown Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538970934
- **Authorized official:** JENNIFER PARDUE (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (502) 548-2402

## Contact information

- **Practice address:** 5525 GEORGETOWN RD STE B, INDIANAPOLIS, IN 46254-3717
- **Practice address phone:** (502) 254-8500
- **Mailing address:** PO BOX 437169, LOUISVILLE, KY 40253-7169
- **Mailing address phone:** (502) 254-8500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | — |

## Other

- **Enumeration date:** 01/15/2025
- **Last updated:** 02/10/2025