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General NPI Number Information
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NPI Number | 1306659230
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Entity Type | Organization
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Legal Business Name | ORTHODONTIC EXPERTS OF INDIANA, LLC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 7365 W 10TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46214-2515
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Country | US
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Telephone | 317-667-0347
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Fax |
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Provider Business Mailing Address
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Address Line | 7365 W 10TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46214-2515
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Country | US
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Telephone | 317-667-0347
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Fax |
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Authorized Official
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Title or Position | VP
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Name | MONIKA BZDAL
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Credential |
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Telephone | 773-941-9224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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