Individual
SUSAN DRAHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
716 RUSSELL AVE, INDIANAPOLIS, IN 46225-1216
(317) 684-1997
(317) 684-1994
Mailing address
716 RUSSELL AVE, INDIANAPOLIS, IN 46225-1216
(317) 684-1997
(317) 684-1994
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
IN12009465
IN
Other
Enumeration date
05/23/2007
Last updated
07/25/2012
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