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General NPI Number Information
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NPI Number | 1588964589
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Entity Type | Organization
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Legal Business Name | JMH DENTAL LLC
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 10/25/2010
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Provider Practice Location Address
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Address Line | 10485 N MICHIGAN RD
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City | CARMEL
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State | IN
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Zip | 46032-7942
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Country | US
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Telephone | 317-875-7645
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Fax |
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Provider Business Mailing Address
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Address Line | 10485 N MICHIGAN RD
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City | CARMEL
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State | IN
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Zip | 46032-7942
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Country | US
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Telephone | 317-875-7645
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE MANAGER
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Name | DENISE BEVER
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Credential |
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Telephone | 317-875-7645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12009335
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License Number State | IN
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