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Organization
GEORGETOWN DENTAL CENTER
Active
Organization
GEORGETOWN DENTAL CENTER
Active
Parent organization
WEST 10TH DENTAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST 10TH DENTAL GROUP
Authorized official
DR. BRENT J BARTA DDS (OWNER)
(317) 247-9512
Entity
Organization
Contact information
Practice address
5525 GEORGETOWN RD, SUITE B, INDIANAPOLIS, IN 46254-3724
(317) 298-9804
(317) 298-0979
Mailing address
5525 GEORGETOWN RD, SUITE B, INDIANAPOLIS, IN 46254-3724
(317) 298-9804
(317) 298-0979
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
120008543
IN
122300000X
Dentist
Primary
12011062
IN
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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