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General NPI Number Information
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NPI Number | 1386452191
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Entity Type | Organization
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Legal Business Name | LUXIA DENTAL LLC
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 44 N GIRLS SCHOOL RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46214-3960
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Country | US
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Telephone | 463-999-9676
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Fax |
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Provider Business Mailing Address
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Address Line | 44 N GIRLS SCHOOL RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46214-3960
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Country | US
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Telephone | 463-999-9676
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Fax |
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Authorized Official
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Title or Position | OPERATIONS AND TRANSITIONS MANAGER
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Name | MRS. MAGGIE MCCLAIN
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Credential |
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Telephone | 860-269-0628
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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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