| Blue River Dental Care, Pc | |
|
1818 N Riley Hwy Ste A Shelbyville IN 46176-9171 | |
| (317) 392-1468 | |
| (317) 398-2573 |
| Full Name | Blue River Dental Care, Pc |
|---|---|
| Speciality | Dentist |
| Location | 1818 N Riley Hwy Ste A, Shelbyville, Indiana |
| Authorized Official Name and Position | Carrie Pumphrey (OWNER) |
| Authorized Official Contact | 3173921468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue River Dental Care, Pc 1818 N Riley Hwy Ste A Shelbyville IN 46176-9171 Ph: (317) 392-1468 | Blue River Dental Care, Pc 1818 N Riley Hwy Ste A Shelbyville IN 46176-9171 Ph: (317) 392-1468 |
| NPI Number | 1396966099 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 03/03/2009 |
| Medicare PECOS PAC ID | 1658628698 |
|---|---|
| Medicare Enrollment ID | O20190123003719 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396966099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12010371 (Indiana) | Primary |
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