| NPI Details | |
|---|---|
| NPI | 1164726832 |
| Enumeration Date | 01/10/2011 |
| Last Updated | 01/10/2011 |
| Entity Type | Healthcare Provider |
| Active | Over 6 years ago |
| Authorized Information | |
|---|---|
| Name | STEPHEN C. STEPHEN |
| Position | PERIODONTIST |
| Phone | (317) 357-2235 |
| Fax | (317) 357-2210 |
| Practice Location | |
|---|---|
| 115 N SHORTRIDGE RD STE 100 INDIANAPOLIS IN, 46219-4917, US |
|
| Phone | (317) 357-2235 |
| Fax | (317) 357-2210 |
| Business Location | |
|---|---|
| 115 N SHORTRIDGE RD STE 100 INDIANAPOLIS IN, 46219-4917, US |
|
| Phone | (317) 357-2235 |
| Fax | (317) 357-2210 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 1223P0300X |
| License State | |
| License Number | |
| Remove 1164726832 NPI Number | |
According to our database, Indy East Periodontics Pc NPI is 1164726832, taxonomy code is 1223P0300X Indy East Periodontics Pc physically located at 115 N Shortridge Rd Ste 100, Indianapolis IN, 46219-4917. NPI Number 1033115704 has the healthcare provider type.
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1164726832 NPI number is provided on an as is basis without warranty of any kind. 1164726832 is maintained by the National Plan & Provider Enumeration System. The contents of Indy East Periodontics Pc are for informational purposes only.
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