| Glendale Family Dentistry, Llc | |
|
2620 E 62nd St Indianapolis IN 46220-2934 | |
| (507) 208-3987 | |
| Not Available |
| Full Name | Glendale Family Dentistry, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2620 E 62nd St, Indianapolis, Indiana |
| Authorized Official Name and Position | Brandon Stafford (OWNER) |
| Authorized Official Contact | 5072083987 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glendale Family Dentistry, Llc 114 Walter Remley Dr Crawfordsville IN 47933-3350 Ph: () - | Glendale Family Dentistry, Llc 2620 E 62nd St Indianapolis IN 46220-2934 Ph: (507) 208-3987 |
| NPI Number | 1013748615 |
|---|---|
| Provider Enumeration Date | 08/13/2024 |
| Last Update Date | 08/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013748615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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