Healthcare Provider Details

I. General information

NPI: 1669338729
Provider Name (Legal Business Name): TRANSFORMATIVE FAMILY DENTISTRY OF SOUTHERN INDIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2026
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 PAOLI PIKE STE 102
FLOYDS KNOBS IN
47119-9681
US

IV. Provider business mailing address

7264 DYLAN DR
BROWNSBURG IN
46112-9769
US

V. Phone/Fax

Practice location:
  • Phone: 812-207-1090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KYLE RATLIFF
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 812-207-1090