Organization
LORIE G BRINSON, DDS, PC
Active
Other names
Lorie G Brinson, DDS, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORIE GOODPASTER BRINSON DDS (PRESIDENT)
(317) 228-0195
Entity
Organization
Contact information
Practice address
3934 W 96TH ST STE B, INDIANAPOLIS, IN 46268-2928
(317) 228-0195
(317) 228-0246
Mailing address
3934 W 96TH ST STE B, INDIANAPOLIS, IN 46268-2928
(317) 228-0195
(317) 228-0246
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
12010346A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972633352
—
IN
Enumeration date
08/24/2017
Last updated
07/21/2022
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