Organization
FISHERS FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY COAD (CREDENTIALING SPECIALIST)
(317) 570-5480
Entity
Organization
Contact information
Practice address
9865 E 116TH ST STE 100, FISHERS, IN 46037-9237
(317) 570-5480
Mailing address
9865 E 116TH ST STE 100, FISHERS, IN 46037-9237
(317) 570-5480
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/18/2019
Last updated
11/18/2019
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