Individual
GREGORY A VELLIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10942 FAWN LAKE DR, INDIANAPOLIS, IN 46278-9552
(317) 339-2268
Mailing address
10942 FAWN LAKE DR, INDIANAPOLIS, IN 46278-9552
(317) 339-2268
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009273
IN
122300000X
Dentist
Primary
12009273A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200313590
—
IN
Enumeration date
02/28/2007
Last updated
07/29/2026
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