Individual
ANDERSON T HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1121 W MICHIGAN ST, DS307B, INDIANAPOLIS, IN 46202-5211
(317) 755-9534
Mailing address
415 LANSING ST, INDIANAPOLIS, IN 46202-2855
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
98000618A
IN
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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