Organization
NORTHEAST ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARISA A WALKER DDS MSP (OWNER)
(317) 849-0110
Entity
Organization
Contact information
Practice address
7205 NORTH SHADELAND AVENUE, INDIANAPOLIS, IN 46250
(317) 849-0110
(317) 845-8845
Mailing address
7205 NORTH SHADELAND AVENUE, INDIANAPOLIS, IN 46250
(317) 849-0110
(317) 845-8845
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12009571A
IN
Other
Enumeration date
05/07/2007
Last updated
08/22/2020
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