# MIDWEST PROSTHODONTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Indiana Restorative Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942709118
- **Authorized official:** TYLER THOMAS DMD (OWNER)
- **Authorized official phone:** (317) 844-4155

## Contact information

- **Practice address:** 370 MEDICAL DR STE B, CARMEL, IN 46032-2971
- **Practice address phone:** (317) 844-4155
- **Practice address fax:** (317) 844-6650
- **Mailing address:** 370 MEDICAL DR STE B, CARMEL, IN 46032-2971
- **Mailing address phone:** (317) 844-4155
- **Mailing address fax:** (317) 844-6650

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 12012667A | IN | Yes |

## Other

- **Enumeration date:** 02/02/2018
- **Last updated:** 02/02/2018