MEDICARE: SADLER ORTHODONTICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	12009379	IN

General Provider Information

NPI Number	:	1558581322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SADLER ORTHODONTICS

Provider Business Mailing Address
First Line	:	11921 LAKESIDE DR
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-1316
Country	:	US
Telephone Number	:	317-594-0888
Fax Number	:	317-594-0286

Provider Business Practice Location Address
First Line	:	11921 LAKESIDE DR
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-1316
Country	:	US
Telephone Number	:	317-594-0888
Fax Number	:	317-594-0286

Authorized Official
Title or Position	:	PRESIDENT, DOCTOR
Name	:	DR. CHARLES A. SADLER
Credential	:	D.D.S., M.S.D.
Telephone Number	:	317-594-0888

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	08/22/2020

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Directions to “SADLER ORTHODONTICS ” Practice Location

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