Organization
THE EXTRA SMILE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY J. HOFTIEZER D.D.S. (PRESIDENT)
(317) 705-5800
Entity
Organization
Contact information
Practice address
1610 GREYHOUND PASS, SUITE #B, CARMEL, IN 46032-5027
(317) 705-5800
Mailing address
1610 GREYHOUND PASS, SUITE #B, CARMEL, IN 46032-5027
(317) 705-5800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009970
IN
Other
Enumeration date
02/07/2011
Last updated
02/07/2011
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