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COLLEGE PARK ORAL & MAXILLOFACIAL SURGERY NPI 1043309719


NPI Information

NPI: 1043309719
Provider Name: COLLEGE PARK ORAL & MAXILLOFACIAL SURGERY
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
3677 W 86TH STREET
INDIANAPOLIS, IN
ZIP 46268
Phone: (317) 872-7777
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COLLEGE PARK ORAL & MAXILLOFACIAL SURGERY is an oral and maxillofacial surgery dentist in Indianapolis, IN. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. COLLEGE PARK ORAL & MAXILLOFACIAL SURGERY NPI is 1043309719. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3677 W 86TH STREET
INDIANAPOLIS, IN
ZIP 46268-902
Phone: (317) 872-7777
Fax: (317) 872-3174

The provider's authorized official is J Harold Smith .
The authorized official title is President and has the following contact phone number (317) 872-7777.

The enumeration date for this NPI number is 10/12/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryINDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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