Individual
DR. PHILIP M MONTEFALCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8445 S EMERSON AVE, SUITE 100, INDIANAPOLIS, IN 46237-9596
(317) 882-1284
(317) 887-0844
Mailing address
10972 ALLISONVILLE RD, SUITE 110, FISHERS, IN 46038-2637
(317) 913-2363
(317) 913-2360
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12009521A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100336020
—
IN
Enumeration date
05/19/2006
Last updated
08/31/2012
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