Organization
FAMILY ORTHODONTICS OF INDIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMONIA LEONARD (CREDENTIALING SPECIALIST)
(678) 244-4844
Entity
Organization
Contact information
Practice address
3905 N WHEELING AVE, MUNCIE, IN 47304-1769
(765) 286-4017
Mailing address
3905 N WHEELING AVE, MUNCIE, IN 47304-1769
(765) 286-4017
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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