Individual
DR. BRADLEY GLENN FAWCETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2440 LAKE CIRCLE DR, INDIANAPOLIS, IN 46268-4219
(317) 872-0800
(317) 872-1224
Mailing address
2440 LAKE CIRCLE DR, INDIANAPOLIS, IN 46268-4219
(317) 872-0800
(317) 872-1224
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009858
IN
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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