Organization
INDY DENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW FRAIZ DMD (DENTIST)
(317) 872-3465
Entity
Organization
Contact information
Practice address
9002 N MERIDIAN ST STE 210, INDIANAPOLIS, IN 46260-5350
(317) 872-3465
(317) 872-4340
Mailing address
9002 N MERIDIAN ST STE 210, INDIANAPOLIS, IN 46260-5350
(317) 872-3465
(317) 872-4340
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12011331C
IN
122300000X
Dentist
Primary
12011779A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134351091
—
IN
05
—
1740578491
—
IN
Enumeration date
05/16/2016
Last updated
05/16/2016
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