Organization
GOODWINE DENTAL, LLC
Active
Other names
Northview Dental
Organization subpart
No
Provider details
NPI number
Authorized official
RONDA RICHELLE COX (OFFICE MANAGER)
(317) 818-7777
Entity
Organization
Contact information
Practice address
210 E 91ST ST STE A, INDIANAPOLIS, IN 46240-1570
(317) 818-7777
(317) 818-7779
Mailing address
210 E 91ST ST STE A, INDIANAPOLIS, IN 46240-1570
(317) 818-7777
(317) 818-7779
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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