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General NPI Number Information
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NPI Number | 1710129580
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH ASSOC OF IN
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Dates
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Enumeration Date | 03/25/2009
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Last Update Date | 03/25/2009
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Provider Practice Location Address
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Address Line | 17419 CAREY RD SUITE B
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City | WESTFIELD
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State | IN
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Zip | 46074-9439
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Country | US
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Telephone | 317-896-8734
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Fax | 317-896-9343
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Provider Business Mailing Address
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Address Line | 17419 CAREY RD SUITE B
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City | WESTFIELD
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State | IN
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Zip | 46074-9439
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Country | US
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Telephone | 317-896-8734
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Fax | 317-896-9343
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. MICHAEL DELANEY
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Credential |
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Telephone | 317-359-3888
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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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