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Organization

GEORGETOWN DENTAL CENTER

Active
Parent organization
WEST 10TH DENTAL GROUP
Organization subpart
Yes

Provider details

NPI number
Legal business name
WEST 10TH DENTAL GROUP
Authorized official
DR. BRENT J BARTA DDS (OWNER)
(317) 247-9512
Entity
Organization

Contact information

Practice address
5525 GEORGETOWN RD, SUITE B, INDIANAPOLIS, IN 46254-3724
(317) 298-9804
(317) 298-0979
Mailing address
5525 GEORGETOWN RD, SUITE B, INDIANAPOLIS, IN 46254-3724
(317) 298-9804
(317) 298-0979

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
120008543
IN
122300000X
Dentist
Primary
12011062
IN

Other

Enumeration date
12/22/2011
Last updated
12/22/2011
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