| Cedar Lane Family Dentistry Pc | |
|
850 Cedar Lane Franklin IN 46131-1089 | |
| (317) 736-7476 | |
| (317) 736-1946 |
| Full Name | Cedar Lane Family Dentistry Pc |
|---|---|
| Speciality | Dentist |
| Location | 850 Cedar Lane, Franklin, Indiana |
| Authorized Official Name and Position | Philip James Mirise (DENTIST CEO) |
| Authorized Official Contact | 3177367476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Lane Family Dentistry Pc 850 Cedar Lane Franklin IN 46131-1089 Ph: (317) 736-7476 | Cedar Lane Family Dentistry Pc 850 Cedar Lane Franklin IN 46131-1089 Ph: (317) 736-7476 |
| NPI Number | 1003976093 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 06/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003976093 | NPI | - | NPPES |
| 200189530A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12009980 (Indiana) | Primary |
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