Organization
FAMILIA DENTAL INDIANAPOLIS AVONDALE, LLC
Active
Other names
Familia Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON ALEXANDER TAYLOR CPCS (CREDENTIALING PAYER RELATIONS MGR)
(847) 453-7396
Entity
Organization
Contact information
Practice address
2940 E 38TH ST STE GHI, INDIANAPOLIS, IN 46218-1217
(888) 988-4066
(847) 496-4850
Mailing address
2050 E ALGONQUIN RD STE 610, SCHAUMBURG, IL 60173-4166
(888) 988-4066
(847) 496-4850
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2017
Last updated
10/15/2021
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