# GEORGETOWN DENTAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WEST 10TH DENTAL GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1871862672
- **Legal business name:** WEST 10TH DENTAL GROUP
- **Authorized official:** DR. BRENT J BARTA DDS (OWNER)
- **Authorized official phone:** (317) 247-9512

## Contact information

- **Practice address:** 5525 GEORGETOWN RD, SUITE B, INDIANAPOLIS, IN 46254-3724
- **Practice address phone:** (317) 298-9804
- **Practice address fax:** (317) 298-0979
- **Mailing address:** 5525 GEORGETOWN RD, SUITE B, INDIANAPOLIS, IN 46254-3724
- **Mailing address phone:** (317) 298-9804
- **Mailing address fax:** (317) 298-0979

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 120008543 | IN | — |
| 122300000X | Dentist | 12011062 | IN | Yes |

## Other

- **Enumeration date:** 12/22/2011
- **Last updated:** 12/22/2011