# EAST INDIANAPOLIS ORAL AND MAXILLOFACIAL SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Steven C. Graham, DDS, Matthew C. Moll, DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942426341
- **Authorized official:** DR. MATTHEW C MOLL DDS (OWNER)
- **Authorized official phone:** (317) 353-1320

## Contact information

- **Practice address:** 125 N SHORTRIDGE RD, INDIANAPOLIS, IN 46219-4908
- **Practice address phone:** (317) 353-1320
- **Practice address fax:** (317) 359-5243
- **Mailing address:** 125 N SHORTRIDGE RD, INDIANAPOLIS, IN 46219-4908
- **Mailing address phone:** (317) 353-1320
- **Mailing address fax:** (317) 359-5243

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 08/22/2020