Organization
EASTERN INDIANA PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES POLAND III DDS (MEMBER)
(317) 566-8183
Entity
Organization
Contact information
Practice address
724 N GRAND AVE, CONNERSVILLE, IN 47331-2015
(765) 825-2051
Mailing address
1840 SUMMERLAKES CT, CARMEL, IN 46032-9392
(317) 566-8183
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12006522B
IN
Other
Enumeration date
05/13/2009
Last updated
05/13/2009
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