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General NPI Number Information
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NPI Number | 1285853028
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Entity Type | Organization
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Legal Business Name | INDIANA FAMILY DENTISTRY, L.L.C.
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 505 N GREEN ST
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City | BROWNSBURG
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State | IN
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Zip | 46112-1026
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Country | US
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Telephone | 317-852-5999
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Fax | 317-852-6624
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Provider Business Mailing Address
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Address Line | 505 N GREEN ST
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City | BROWNSBURG
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State | IN
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Zip | 46112-1026
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Country | US
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Telephone | 317-852-5999
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Fax | 317-852-6624
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. WILLIAM C. HINE JR.
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Credential | D.D.S.
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Telephone | 317-852-5999
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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 | 12009870
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License Number State | IN
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