| Fortville Family Denistry Llc | |
|
14 S Main St Fortville IN 46040-1315 | |
| (317) 485-5251 | |
| Not Available |
| Full Name | Fortville Family Denistry Llc |
|---|---|
| Speciality | Dentist |
| Location | 14 S Main St, Fortville, Indiana |
| Authorized Official Name and Position | Bradley Paul Laconi (OWNER) |
| Authorized Official Contact | 3174855251 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fortville Family Denistry Llc 14 S Main St Fortville IN 46040-1315 Ph: (317) 485-5251 | Fortville Family Denistry Llc 14 S Main St Fortville IN 46040-1315 Ph: (317) 485-5251 |
| NPI Number | 1063657187 |
|---|---|
| Provider Enumeration Date | 12/03/2008 |
| Last Update Date | 12/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063657187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12008802B (Indiana) | Primary |
Indy Dental Group Fortville, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 727 E Broadway St, Fortville, IN 46040 Phone: 317-399-5513 | |
Advanced Dental Care Of Fortville, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 545 Vitality Dr Ste F, Fortville, IN 46040 Phone: 317-485-7000 |