Organization
PREMIER ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYRAH IMTIAZ QURAISHI DDS, MS (OWNER)
(317) 998-7645
Entity
Organization
Contact information
Practice address
8860 ZIONSVILLE RD STE B, INDIANAPOLIS, IN 46268-1043
(317) 998-7645
Mailing address
8860 ZIONSVILLE RD STE B, INDIANAPOLIS, IN 46268-1043
(317) 998-7645
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12012422A
IN
Other
Enumeration date
06/09/2017
Last updated
07/21/2022
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