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General NPI Number Information
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NPI Number | 1871085167
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Entity Type | Organization
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Legal Business Name | BRACES FOR U
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 9126 TECHNOLOGY LN
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City | FISHERS
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State | IN
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Zip | 46038-3064
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Country | US
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Telephone | 317-797-6688
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Fax |
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Provider Business Mailing Address
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Address Line | 4222 KATTMAN CT
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City | CARMEL
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State | IN
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Zip | 46074-1108
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Country | US
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Telephone | 317-797-6688
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. PRITI RANA MAHAJAN
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Credential | DMD
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Telephone | 317-797-6688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12011584A
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License Number State | IN
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