# SOUTH CENTRAL ENDODONTICS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1922200567
- **Authorized official:** DR. MICHAEL E. KELLER D.D.S. ,M.S.D. (OWNER)
- **Authorized official phone:** (812) 372-3636

## Contact information

- **Practice address:** 3200 MIDDLE DR, COLUMBUS, IN 47203-4426
- **Practice address phone:** (812) 372-3636
- **Practice address fax:** (812) 378-3636
- **Mailing address:** 3200 MIDDLE DR, COLUMBUS, IN 47203-4426
- **Mailing address phone:** (812) 372-3636
- **Mailing address fax:** (812) 378-3636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 12008103B | IN | Yes |

## Other

- **Enumeration date:** 06/05/2007
- **Last updated:** 06/30/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 405356 | UNITED CONCORDIA ID | IN |