Organization
MERIDIAN STREET PERIODONTICS, LLC
Active
Other names
Implant Dentistry and Periodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY THURMAN EFDA (OFFICE MANAGER)
(317) 842-8453
Entity
Organization
Contact information
Practice address
8801 N MERIDIAN ST STE 103, INDIANAPOLIS, IN 46260-2353
(317) 574-0600
(317) 574-0606
Mailing address
8037 SARGENT RDG, INDIANAPOLIS, IN 46256-1848
(317) 574-0600
(317) 574-0606
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12010349A
IN
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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