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General NPI Number Information
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NPI Number | 1720952948
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Entity Type | Organization
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Legal Business Name | BRAVIA SERVICES LLC
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 13390 OVERVIEW DR STE 201
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City | FISHERS
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State | IN
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Zip | 46037-6314
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Country | US
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Telephone | 317-773-5833
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Fax |
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Provider Business Mailing Address
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Address Line | 9465 COUNSELORS ROW STE 200
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-3817
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Country | US
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Telephone | 317-525-3703
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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. DOUGLAS HEATH
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Credential |
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Telephone | 317-590-3684
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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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