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General NPI Number Information
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NPI Number | 1336361708
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Entity Type | Organization
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Legal Business Name | DENTAL PROFESSIONALS OF INDIANA, P.C.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 986 NORTH MITTHOEFFER
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City | INDIANAPOLIS
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State | IN
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Zip | 46229
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Country | US
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Telephone | 317-899-3106
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Fax | 317-899-3141
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Provider Business Mailing Address
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Address Line | 986 NORTH MITTHOEFFER
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City | INDIANAPOLIS
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State | IN
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Zip | 46229
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Country | US
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Telephone | 317-899-3106
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Fax | 317-899-3141
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Authorized Official
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Title or Position | INSURANCE/CREDENTIALING
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Name | JENNIFER HOELSCHER
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Credential |
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Telephone | 217-540-5100
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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 |
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License Number State |
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