Provider Demographics
NPI:1073011078
Name:HARTMAN DENTISTRY LLC
Entity Type:Organization
Organization Name:HARTMAN DENTISTRY LLC
Other - Org Name:JOHN H HARTMAN DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-581-0215
Mailing Address - Street 1:3091 E 98TH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-1970
Mailing Address - Country:US
Mailing Address - Phone:317-581-0215
Mailing Address - Fax:317-581-0219
Practice Address - Street 1:3091 E 98TH ST STE 220
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-1970
Practice Address - Country:US
Practice Address - Phone:317-581-0215
Practice Address - Fax:317-581-0219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009074A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty