| Broad Ripple Family Dental, Llc | |
|
6117 N College Ave Indianapolis IN 46220-2233 | |
| (317) 257-3368 | |
| Not Available |
| Full Name | Broad Ripple Family Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6117 N College Ave, Indianapolis, Indiana |
| Authorized Official Name and Position | Gina Elrod (DENTIST) |
| Authorized Official Contact | 3172573368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broad Ripple Family Dental, Llc 6117 N. College Indianapolis IN 46220 Ph: (317) 257-3368 | Broad Ripple Family Dental, Llc 6117 N College Ave Indianapolis IN 46220-2233 Ph: (317) 257-3368 |
| NPI Number | 1073840393 |
|---|---|
| Provider Enumeration Date | 11/06/2009 |
| Last Update Date | 11/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073840393 | NPI | - | NPPES |
| 100061910A | Medicaid | IN |
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