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General NPI Number Information
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NPI Number | 1548339823
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Entity Type | Organization
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Legal Business Name | DAVID GORIS, D.D.S., P.C.
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 201 S EMERSON AVE STE 130
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City | GREENWOOD
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State | IN
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Zip | 46143-1916
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Country | US
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Telephone | 317-888-4044
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Fax | 317-888-4073
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Provider Business Mailing Address
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Address Line | 1550 REDSUNSET DR
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City | BROWNSBURG
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State | IN
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Zip | 46112-7734
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID GORIS
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Credential | D.D.S.
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Telephone | 317-888-4044
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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 | 12010322
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License Number State | IN
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