Organization
IMBURGIA ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY IMBURGIA DDS (SOLE MEMBER)
(317) 997-7930
Entity
Organization
Contact information
Practice address
2230 STAFFORD RD, SUITE 157, PLAINFIELD, IN 46168-2789
(317) 296-5388
Mailing address
2230 STAFFORD RD, SUITE 157, PLAINFIELD, IN 46168-2789
(317) 296-5388
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
06/29/2013
Last updated
07/01/2013
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