| Michael F. Tillery Dds & Associates Pc | |
|
3410 N High School Rd Ste B Indianapolis IN 46224-0002 | |
| (317) 291-8957 | |
| (317) 291-2115 |
| Full Name | Michael F. Tillery Dds & Associates Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3410 N High School Rd Ste B, Indianapolis, Indiana |
| Authorized Official Name and Position | Michael Fredrick Tillery (OWNER) |
| Authorized Official Contact | 3172918957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael F. Tillery Dds & Associates Pc 3410 N High School Rd Ste B Indianapolis IN 46224-0002 Ph: (317) 291-8957 | Michael F. Tillery Dds & Associates Pc 3410 N High School Rd Ste B Indianapolis IN 46224-0002 Ph: (317) 291-8957 |
| NPI Number | 1609286061 |
|---|---|
| Provider Enumeration Date | 05/06/2014 |
| Last Update Date | 05/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609286061 | NPI | - | NPPES |
| 100062710A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7704 (Indiana) | Primary |
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