Organization
VILLAGE DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINA HUBBARD (DISTRICT MANAGER)
(317) 773-5833
Entity
Organization
Contact information
Practice address
13578 E 131ST ST, FISHERS, IN 46037-6400
(317) 773-5833
(317) 773-5991
Mailing address
13578 E 131ST ST, FISHERS, IN 46037-6400
(317) 773-5833
(317) 773-5991
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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