Organization
GREAT LAKES FAMILY DENTAL GROUP-INDIANAPOLIS
Active
Other names
Great Lakes Family Dental Group-Indianapolis
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA J HART (CORPORATE MANAGER)
(317) 841-1111
Entity
Organization
Contact information
Practice address
7465 E 82ND ST, INDIANAPOLIS, IN 46256-1459
(317) 841-1111
Mailing address
7465 E 82ND ST, INDIANAPOLIS, IN 46256-1459
(317) 841-1111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/16/2015
Last updated
11/16/2015
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