Individual
LORI SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9310 N MERIDIAN ST STE 200, INDIANAPOLIS, IN 46260-0001
(317) 846-6125
Mailing address
9310 N MERIDIAN ST STE 200, INDIANAPOLIS, IN 46260-0001
(317) 846-6125
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010537A
IN
Other
Enumeration date
04/17/2008
Last updated
04/17/2008
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