| Edp Of Indiana, Pc | |
|
5470 Lafayette Rd Indianapolis IN 46254-1620 | |
| (317) 293-4611 | |
| Not Available |
| Full Name | Edp Of Indiana, Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5470 Lafayette Rd, Indianapolis, Indiana |
| Authorized Official Name and Position | Roseanne Brunenkant (DIRECTOR OF INTEGRATION) |
| Authorized Official Contact | 3129373619 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edp Of Indiana, Pc 141 W Jackson Blvd Ste 210 Chicago IL 60604-3048 Ph: (312) 937-3619 | Edp Of Indiana, Pc 5470 Lafayette Rd Indianapolis IN 46254-1620 Ph: (317) 293-4611 |
| NPI Number | 1548776685 |
|---|---|
| Provider Enumeration Date | 12/27/2017 |
| Last Update Date | 09/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548776685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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