Organization
SHANK ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE BROOKE SHANK D.D.S, M.S. (SOLE MEMBER)
(317) 888-9833
Entity
Organization
Contact information
Practice address
1700 W SMITH VALLEY RD, SUITE A-1, GREENWOOD, IN 46142-1599
(317) 888-9833
(317) 885-1754
Mailing address
1700 W SMITH VALLEY RD, SUITE A-1, GREENWOOD, IN 46142-1599
(317) 888-9833
(317) 885-1754
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12011699A
IN
Other
Enumeration date
07/14/2011
Last updated
11/04/2016
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