# INDIANAPOLIS CENTER FOR IMPLANT AND COSMETIC DENTISTRY PC

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

## Provider details

- **NPI number:** 1912335464
- **Authorized official:** TED REESE DDS (PRESIDENT)
- **Authorized official phone:** (317) 882-0228

## Contact information

- **Practice address:** 7218 US 31 S, INDIANAPOLIS, IN 46227-8539
- **Practice address phone:** (317) 882-0228
- **Mailing address:** 7218 US 31 S, INDIANAPOLIS, IN 46227-8539
- **Mailing address phone:** (317) 882-0228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12008609A | IN | Yes |

## Other

- **Enumeration date:** 10/21/2013
- **Last updated:** 10/21/2013