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General NPI Number Information
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NPI Number | 1639652126
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Entity Type | Organization
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Legal Business Name | GH DENTAL
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 6925 S HARDING ST STE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46217-4114
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Country | US
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Telephone | 317-865-8125
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Fax |
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Provider Business Mailing Address
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Address Line | 1812 GOLDEN FIELD DR
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City | GREENWOOD
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State | IN
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Zip | 46143-6236
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Country | US
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Telephone | 317-985-0974
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. COURTNEY GEIGER
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Credential | DDS
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Telephone | 317-985-0974
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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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