| Image Orthodontics Pc | |
|
1748 Northwestern Ave West Lafayette IN 47906-2271 | |
| (765) 463-6622 | |
| Not Available |
| Full Name | Image Orthodontics Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1748 Northwestern Ave, West Lafayette, Indiana |
| Authorized Official Name and Position | Ryan Bradley Helms (PRESIDENT) |
| Authorized Official Contact | 7654901031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Image Orthodontics Pc 1748 Northwestern Ave West Lafayette IN 47906-2271 Ph: (765) 463-6622 | Image Orthodontics Pc 1748 Northwestern Ave West Lafayette IN 47906-2271 Ph: (765) 463-6622 |
| NPI Number | 1063768471 |
|---|---|
| Provider Enumeration Date | 08/03/2012 |
| Last Update Date | 08/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063768471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 54001743A (Indiana) | Primary |
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