Organization
FISHERS ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D BENNETT DDS (PRESIDENT SURGEON)
(317) 849-3667
Entity
Organization
Contact information
Practice address
9126 TECHNOLOGY LN, STE 300, FISHERS, IN 46038-3064
(317) 849-3667
(317) 849-3668
Mailing address
9126 TECHNOLOGY LN, STE 300, FISHERS, IN 46038-3064
(317) 849-3667
(317) 849-3668
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12007758
IN
Other
Enumeration date
08/10/2006
Last updated
10/29/2012
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