Organization
STEVE DOUGLAS, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVE DOUGLAS DDS (OWNER)
(317) 786-1277
Entity
Organization
Contact information
Practice address
6745 GRAY RD, SUITE F, INDIANAPOLIS, IN 46237-3262
(317) 786-1277
(317) 786-1497
Mailing address
6745 GRAY RD, SUITE F, INDIANAPOLIS, IN 46237-3262
(317) 786-1277
(317) 786-1497
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009346
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100102910A
—
IN
Enumeration date
01/18/2011
Last updated
01/18/2011
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