Provider Demographics
NPI:1043483373
Name:CORPORATE DENTAL CENTERS
Entity Type:Organization
Organization Name:CORPORATE DENTAL CENTERS
Other - Org Name:EDWARD GARRY FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:GARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:317-865-3733
Mailing Address - Street 1:1405 W COUNTY LINE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-5123
Mailing Address - Country:US
Mailing Address - Phone:317-865-3733
Mailing Address - Fax:317-865-3740
Practice Address - Street 1:1405 W COUNTY LINE RD
Practice Address - Street 2:SUITE A
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-5123
Practice Address - Country:US
Practice Address - Phone:317-865-3733
Practice Address - Fax:317-865-3740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty