Individual
ELIZABETH WYETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDH
Contact information
Practice address
1121 W MICHIGAN ST # E116, INDIANAPOLIS, IN 46202-5186
(317) 278-8177
Mailing address
7486 FOX HOLLOW CT, ZIONSVILLE, IN 46077-8393
(317) 840-3997
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13005033A
IN
Other
Enumeration date
10/05/2006
Last updated
02/24/2021
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