Organization
CENTER FOR IMPLANT DENISTRY AND PERIODONTICS, LLC
Active
Other names
Implant Dentistry and Periodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY THURMAN EFDA (OFFICE MANAGER)
(317) 842-8453
Entity
Organization
Contact information
Practice address
9885 E 116TH ST STE 300, FISHERS, IN 46037-9242
(317) 842-2273
(317) 842-7911
Mailing address
8037 SARGENT RDG, INDIANAPOLIS, IN 46256-1848
(317) 842-2273
(317) 842-7911
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12010349A
IN
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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