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General NPI Number Information
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NPI Number | 1669588125
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Entity Type | Organization
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Legal Business Name | GERALD M LANDE, DDS, PC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 9699 N MICHIGAN RD
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City | CARMEL
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State | IN
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Zip | 46032-9639
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Country | US
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Telephone | 317-875-9531
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Fax |
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Provider Business Mailing Address
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Address Line | 9699 N MICHIGAN RD
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City | CARMEL
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State | IN
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Zip | 46032-9639
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Country | US
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Telephone | 317-875-9531
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERALD M LANDE
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Credential | DDS
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Telephone | 317-875-9531
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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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