Individual
DR. JOHN RUSSELL PHELPS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Contact information
Practice address
9011 N MERIDIAN ST, INDIANAPOLIS, IN 46260-5301
(317) 818-9858
(317) 818-1716
Mailing address
4609 CRANBROOK DR, INDIANAPOLIS, IN 46250-2434
(317) 595-0318
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
12009486
IN
Other
Enumeration date
01/27/2006
Last updated
11/06/2007
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