Organization
TEVERBAUGH4 LLC
Active
Other names
Teverbaugh Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANA TEVERBAUGH (DENTIST)
(317) 572-8626
Entity
Organization
Contact information
Practice address
10967 ALLISONVILLE RD, SUITE 200, FISHERS, IN 46038-2632
(317) 572-8626
Mailing address
10967 ALLISONVILLE RD, SUITE 200, FISHERS, IN 46038-2632
(317) 572-8626
(317) 284-1276
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011392A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2009779108
—
IN
Enumeration date
03/19/2013
Last updated
06/24/2013
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