Organization
DENTAL PROFESSIONALS OF INDIANA, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF INDIANA, P.C.
Other names
Grand Maple Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF INDIANA, P.C.
Authorized official
CEMYIRA MCDOUGAL (CREDENTIALING COORDINATOR)
(217) 764-8609
Entity
Organization
Contact information
Practice address
249 W TOURNAMENT TRL, WESTFIELD, IN 46074-6223
(463) 622-2060
(463) 622-2059
Mailing address
249 W TOURNAMENT TRL, WESTFIELD, IN 46074-6223
(463) 622-2060
(463) 622-2059
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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