Organization
NORTHEAST DENTAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD A. LEVIN DDS (PRESIDENT)
(317) 596-9700
Entity
Organization
Contact information
Practice address
8202 CLEARVISTA PKWY, STE 10A, INDIANAPOLIS, IN 46256-1400
(317) 596-9700
Mailing address
8202 CLEARVISTA PKWY, STE 10A, INDIANAPOLIS, IN 46256-1400
(317) 596-9700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007689A
IN
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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