Provider Demographics
NPI:1003306259
Name:ATKINSON FAMILY DENTAL
Entity Type:Organization
Organization Name:ATKINSON FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:574-360-6461
Mailing Address - Street 1:2037 STANHOPE ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7238
Mailing Address - Country:US
Mailing Address - Phone:574-360-6461
Mailing Address - Fax:
Practice Address - Street 1:9893 N MICHIGAN RD STE 180
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-7966
Practice Address - Country:US
Practice Address - Phone:317-872-6326
Practice Address - Fax:317-872-6325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011661A261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental