Healthcare Provider Details

I. General information

NPI: 1154710267
Provider Name (Legal Business Name): LAWRENCE G. FALENDER DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 N POST RD
INDIANAPOLIS IN
46219-4210
US

IV. Provider business mailing address

1320 N POST RD
INDIANAPOLIS IN
46219-4210
US

V. Phone/Fax

Practice location:
  • Phone: 317-898-2555
  • Fax: 317-898-2556
Mailing address:
  • Phone: 317-898-2555
  • Fax: 317-898-2556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number12008529
License Number StateIN

VIII. Authorized Official

Name: DR. LAWRENCE FALENDER
Title or Position: OWNER
Credential: DDS
Phone: 317-898-2555