Organization
MY INDY DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT J BARTA DDS (MEMBER)
(317) 247-9512
Entity
Organization
Contact information
Practice address
3804 N DELAWARE ST, INDIANAPOLIS, IN 46205-2648
(317) 925-4202
Mailing address
6443 W 10TH ST STE 204, INDIANAPOLIS, IN 46214-6502
(317) 247-9512
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/11/2021
Last updated
09/11/2021
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