Individual
LIYA GEBRU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10110 E WASHINGTON ST, STE E, INDIANAPOLIS, IN 46229-2638
(317) 897-0200
Mailing address
6562 WESTLAND DR, BROWNSBURG, IN 46112-7412
(317) 460-6378
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013802A
IN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/17/2022
Last updated
06/14/2022
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