Organization
FALL CREEK DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE EDLEY (OFFICE MANAGER)
(317) 596-8000
Entity
Organization
Contact information
Practice address
10106 BROOKS SCHOOL RD, SUITE 500, FISHERS, IN 46037-9804
(317) 596-8000
(317) 596-0671
Mailing address
10106 BROOKS SCHOOL RD, SUITE 500, FISHERS, IN 46037-9804
(317) 596-8000
(317) 596-0671
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010202
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00720339
UNITED CONCORDIA
IN
Enumeration date
07/20/2006
Last updated
08/22/2020
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