Organization
EAST CENTRAL INDIANA ORAL AND MAXILLOFACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARRY PAPADOPOULOS DDS, MD (PRACTICE CO-OWNER)
(765) 281-1131
Entity
Organization
Contact information
Practice address
3895 N WHEELING AVE, MUNCIE, IN 47304-1776
(765) 281-1131
Mailing address
3895 N WHEELING AVE, MUNCIE, IN 47304-1776
(765) 281-1131
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
12008702A
IN
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
12010966A
IN
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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