Organization
EMHARDT PEDIATRIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN RAY EMHARDT DDS, MSD (PEDIATRIC DENTIST/OWNER)
(317) 507-3439
Entity
Organization
Contact information
Practice address
1818 N RILEY HWY STE B, SHELBYVILLE, IN 46176-8572
(317) 507-3439
Mailing address
151 S EAST ST APT 309, INDIANAPOLIS, IN 46202-4075
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12012171A
IN
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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