Organization
ALDRICH PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON JONES (FRONT OFFICE)
(463) 701-5437
Entity
Organization
Contact information
Practice address
10373 E COUNTY ROAD 100 N, INDIANAPOLIS, IN 46234-1250
(463) 701-5437
(463) 209-0482
Mailing address
10373 E COUNTY ROAD 100 N, INDIANAPOLIS, IN 46234-1250
(463) 701-5437
(463) 209-0482
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12011675A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201097750A
—
IN
Enumeration date
08/17/2018
Last updated
08/17/2018
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