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NPI Code Detail

MEDICARE: GEORGE E KIRTLEY DDS

MEDICARE:   GEORGE E KIRTLEY  DDS
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
11223G0001XGeneral Practice Dentistry12007624IN

General Provider Information

NPI Number : 1790803393
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE E KIRTLEY DDS
Provider Business Mailing Address
First Line : 7465 E 82ND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1459
Country : US
Telephone Number : 317-841-1111
Fax Number : 317-841-3394
Provider Business Practice Location Address
First Line : 7465 E 82ND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1459
Country : US
Telephone Number : 317-841-1111
Fax Number : 317-841-3394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 07/08/2007

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Directions to “ GEORGE E KIRTLEY DDS” Practice Location

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