# WESTSIDE FAMILY DENTAL

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

## Provider details

- **NPI number:** 1720414311
- **Authorized official:** STEPHEN A TRAGER DDS (OWNER)
- **Authorized official phone:** (317) 241-9876

## Contact information

- **Practice address:** 4318 W WASHINGTON ST, INDIANAPOLIS, IN 46241-0822
- **Practice address phone:** (317) 241-9876
- **Practice address fax:** (317) 247-4877
- **Mailing address:** 4318 W WASHINGTON ST, INDIANAPOLIS, IN 46241-0822
- **Mailing address phone:** (317) 241-9876
- **Mailing address fax:** (317) 247-4877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12010793A | IN | Yes |

## Other

- **Enumeration date:** 09/16/2013
- **Last updated:** 09/16/2013