# INDIANA EMERGENCY DENTAL FISHERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Indiana Emergency Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578350641
- **Authorized official:** MALLORY ELLIS (OFFICE ADMIN)
- **Authorized official phone:** (463) 276-0541

## Contact information

- **Practice address:** 9860 WESTPOINT DR STE 100, INDIANAPOLIS, IN 46256-3398
- **Practice address phone:** (463) 276-0541
- **Mailing address:** 7015 US 31 STE C, INDIANAPOLIS, IN 46227-8619
- **Mailing address phone:** (463) 276-0541
- **Mailing address fax:** (463) 276-0541

## Taxonomy

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

## Other

- **Enumeration date:** 04/22/2025
- **Last updated:** 04/23/2025