Organization
IN ORAL AND FACIAL SURGERY
Active
Other names
Indianapolis Oral Surgery and Dental Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE HOLLOWAY (DIRECTOR OF RCM)
(854) 200-7970
Entity
Organization
Contact information
Practice address
1320 N POST RD, INDIANAPOLIS, IN 46219-4210
(317) 898-2555
Mailing address
3700 INGLESIDE BLVD, LADSON, SC 29456-4141
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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