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General NPI Number Information
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NPI Number | 1972292381
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Entity Type | Organization
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Legal Business Name | GLOBAL SMILES DENTAL 9 LLC
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 4740 W 38TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-3318
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Country | US
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Telephone | 317-622-0873
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Fax |
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Provider Business Mailing Address
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Address Line | 4740 W 38TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-3318
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Country | US
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Telephone | 317-622-0873
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | TIA WHITE
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Credential |
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Telephone | 317-956-5035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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