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General NPI Number Information
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NPI Number | 1578697165
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Entity Type | Organization
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Legal Business Name | SMITH BRIDENSTINE OPTICIANS
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 3950 E 82ND ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-2467
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Country | US
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Telephone | 317-578-7897
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Fax | 317-578-7853
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Provider Business Mailing Address
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Address Line | 3950 E 82ND ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-2467
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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 | PRESIDENT
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Name | MR. WILLIAM H BRIDENSTINE
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Credential |
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Telephone | 317-578-7897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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