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Organization
FORTVILLE SMILE STATION
Active
Organization
FORTVILLE SMILE STATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALLORIE NICOLE LAWSON DDS (DENTIST)
(317) 485-6477
Entity
Organization
Contact information
Practice address
727 E BROADWAY ST, FORTVILLE, IN 46040-1565
(317) 485-6477
Mailing address
727 E BROADWAY ST, FORTVILLE, IN 46040-1565
(317) 485-6477
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/13/2026
Last updated
08/13/2026
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