# ROCKVILLE ROAD DENTISTRY

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

## Provider details

- **NPI number:** 1649380452
- **Authorized official:** FRIEDA COOKE DO (PRESIDENT)
- **Authorized official phone:** (317) 227-0881

## Contact information

- **Practice address:** 6355 ROCKVILLE ROAD, INDIANAPOLIS, IN 46214
- **Practice address phone:** (317) 227-0581
- **Practice address fax:** (317) 227-0820
- **Mailing address:** 6355 ROCKVILLE ROAD, INDIANAPOLIS, IN 46214
- **Mailing address phone:** (317) 227-0581
- **Mailing address fax:** (317) 227-0820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009952 | IN | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 02/07/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200194500A | — | IN |