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General NPI Number Information
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NPI Number | 1356509731
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Entity Type | Organization
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Legal Business Name | SARA P. VIERNES DDS PC
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 6820 PARKDALE PLACE SUITE 117
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-4699
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Country | US
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Telephone | 317-329-7373
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Fax | 317-329-7380
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Provider Business Mailing Address
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Address Line | 6820 PARKDALE PLACE SUITE 117
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-4699
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Country | US
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Telephone | 317-329-7373
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Fax | 317-329-7380
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Authorized Official
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Title or Position | OWNER
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Name | DR. SARA P VIERNES
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Credential | DDS
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Telephone | 317-329-7373
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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 | 12010470A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12011023A
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License Number State | IN
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