Organization
INDY EAST PERIODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN C. KOEHLER DDS, MSD (PERIODONTIST)
(317) 357-2235
Entity
Organization
Contact information
Practice address
115 N SHORTRIDGE RD STE 100, INDIANAPOLIS, IN 46219-4917
(317) 357-2235
(317) 357-2210
Mailing address
115 N SHORTRIDGE RD STE 100, INDIANAPOLIS, IN 46219-4917
(317) 357-2235
(317) 357-2210
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
IN
Other
Enumeration date
01/10/2011
Last updated
01/10/2011
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