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Organization

POPLAR PEDIATRIC DENTISTRY LLC

Active
Parent organization
POPLAR PEDIATRIC DENTISTRY LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
POPLAR PEDIATRIC DENTISTRY LLC
Authorized official
DR. KATELYN BRAUER DDS (OWNER)
(317) 939-6558
Entity
Organization

Contact information

Practice address
1667 N LEBANON ST, LEBANON, IN 46052-1515
(317) 939-6558
Mailing address
6828 W STONEGATE DR, ZIONSVILLE, IN 46077-8023
(317) 939-6558

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
09/06/2023
Last updated
01/01/2024
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