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General NPI Number Information
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NPI Number | 1003708215
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Entity Type | Organization
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Legal Business Name | WATERFRONT FAMILY DENTAL
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 11481 OLIO RD
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City | FISHERS
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State | IN
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Zip | 46037
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Country | US
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Telephone | 317-771-9244
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Fax |
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Provider Business Mailing Address
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Address Line | 653 RIDGE GATE DR
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City | BROWNSBURG
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State | IN
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Zip | 46112-7801
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Country | US
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Telephone | 317-771-9244
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHIKHA GILL
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Credential |
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Telephone | 317-771-9244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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