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General NPI Number Information
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NPI Number | 1962225714
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Entity Type | Individual
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Provider Name | GRAZIELA RIBEIRO BATISTA DDS, MSC, PHD
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Gender | Female
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Dates
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Enumeration Date | 10/31/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 1121 W MICHIGAN ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5211
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Country | US
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Telephone | 317-274-7433
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Fax |
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Provider Business Mailing Address
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Address Line | 515 E 22ND ST APT 5307
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-1691
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Country | US
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Telephone | 660-234-1933
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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 | LDF240032
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License Number State | IN
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