# CENTRAL INDIANA PERIODONTICS, PC

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

## Provider details

- **NPI number:** 1831359470
- **Authorized official:** DR. DANIEL GOMES DDS, MSD (OWNER)
- **Authorized official phone:** (317) 299-4731

## Contact information

- **Practice address:** 8235 COUNTRY VILLAGE DR, INDIANAPOLIS, IN 46214
- **Practice address phone:** (317) 299-4731
- **Practice address fax:** (317) 329-5054
- **Mailing address:** 8235 COUNTRY VILLAGE DR, INDIANAPOLIS, IN 46214
- **Mailing address phone:** (317) 299-4731
- **Mailing address fax:** (317) 329-5054

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12010704A | IN | Yes |

## Other

- **Enumeration date:** 06/16/2008
- **Last updated:** 05/01/2017