MEDICARE: DR. EDWARD EROTAS JR. 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
1	122300000X	Dentist	12008382A	IN

General Provider Information

NPI Number	:	1922119403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD EROTAS JR. DDS

Provider Business Mailing Address
First Line	:	ONE AMERICAN SQUARE
Second Line	:	STE 165
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46282
Country	:	US
Telephone Number	:	317-955-3988
Fax Number	:	317-955-6904

Provider Business Practice Location Address
First Line	:	ONE AMERICAN SQUARE
Second Line	:	STE 165
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46282
Country	:	US
Telephone Number	:	317-955-3988
Fax Number	:	317-955-6904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. EDWARD EROTAS JR. DDS” Practice Location

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