MEDICARE: DR. SCOTT ANDREW CHRISTY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8230	IN

General Provider Information

NPI Number	:	1265566111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ANDREW CHRISTY DDS

Provider Business Mailing Address
First Line	:	4407 BRIARWOOD DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2416
Country	:	US
Telephone Number	:	317-253-5304
Fax Number	:	317-253-5301

Provider Business Practice Location Address
First Line	:	6201 WINTHROP AVE
Second Line	:	SUITE #3
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-1970
Country	:	US
Telephone Number	:	317-253-5304
Fax Number	:	317-253-5301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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