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General NPI Number Information
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NPI Number | 1760553937
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Entity Type | Individual
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Provider Name | HELEN KATIE PETERSON DDS
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Gender | Female
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 2802 LAFAYETTE RD STE 33
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-2112
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Country | US
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Telephone | 317-925-2810
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Fax |
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Provider Business Mailing Address
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Address Line | 6005 E WASHINGTON ST STE 101
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-6616
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Country | US
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Telephone | 317-322-1840
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12010757A
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License Number State | IN
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