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General NPI Number Information
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NPI Number | 1114137932
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Entity Type | Organization
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Legal Business Name | DENTISTRY ON 116, INC.
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 890 E 116TH ST SUITE 210
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City | CARMEL
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State | IN
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Zip | 46032-3475
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Country | US
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Telephone | 317-575-8993
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Fax | 317-575-8987
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Provider Business Mailing Address
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Address Line | 890 E 116TH ST SUITE 210
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City | CARMEL
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State | IN
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Zip | 46032-3475
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Country | US
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Telephone | 317-575-8993
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Fax | 317-575-8987
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Authorized Official
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Title or Position | OWNER
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Name | DR. AILEEN CASTOR HELTON
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Credential | DDS
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Telephone | 317-575-8993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12010254A
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License Number State | IN
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