Organization
NORTHEAST DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME CURETON DDS (PRINCIPAL MEMBER)
(317) 989-5534
Entity
Organization
Contact information
Practice address
6132 ALLISONVILLE RD, INDIANAPOLIS, IN 46220-4608
(317) 259-7310
(317) 259-7321
Mailing address
6132 ALLISONVILLE RD, INDIANAPOLIS, IN 46220-4608
(317) 259-7310
(317) 259-7321
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009713
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558448043
INDIVIDUAL NPI NUMBER
IN
05
—
200014250B
—
IN
Enumeration date
08/20/2015
Last updated
08/20/2015
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