Organization
GERMAN CHURCH RD FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE COOMBS (OFFICE MANAGER)
(317) 898-9231
Entity
Organization
Contact information
Practice address
11020 E 10TH ST STE A, INDIANAPOLIS, IN 46229-3710
(317) 898-9231
(317) 898-9245
Mailing address
11020 E 10TH ST STE A, INDIANAPOLIS, IN 46229-3710
(317) 898-9231
(317) 898-9245
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007959A
IN
1223G0001X
General Practice Dentistry
120111490A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100065700A
—
IN
Enumeration date
01/22/2014
Last updated
01/22/2014
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