Organization
INDIANA ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC
Active
Other names
Indiana Oral and Maxillofacial Surgery Associates
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH MILLER (ADMINISTRATOR)
(317) 913-2363
Entity
Organization
Contact information
Practice address
10972 ALLISONVILLE RD, SUITE 110, FISHERS, IN 46038-2637
(317) 913-2363
(317) 913-2370
Mailing address
10972 ALLISONVILLE RD, SUITE 110, FISHERS, IN 46038-2637
(317) 913-2363
(317) 913-2370
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100059140
—
IN
Enumeration date
05/18/2006
Last updated
03/13/2026
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