Individual
MILLIE MARY CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8136 BASH ST, INDIANAPOLIS, IN 46250-2000
(317) 577-6453
(317) 577-6456
Mailing address
3959 CHADWICK DR, CARMEL, IN 46033-4810
(317) 569-0281
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010347A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200421250
—
IN
Enumeration date
08/29/2006
Last updated
09/25/2009
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