Individual
DR. ELIZABETH MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3401 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 957-2450
Mailing address
3403 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 957-2000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN122724
GA
1223G0001X
General Practice Dentistry
Primary
12014060A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300077715
—
IN
Enumeration date
06/22/2022
Last updated
03/15/2024
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