Provider Demographics
NPI:1104836386
Name:COMPLETE FAMILY DENTISTRY, PC
Entity Type:Organization
Organization Name:COMPLETE FAMILY DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BIERMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:317-293-4020
Mailing Address - Street 1:2955 N HIGH SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-2915
Mailing Address - Country:US
Mailing Address - Phone:317-293-4020
Mailing Address - Fax:317-293-4064
Practice Address - Street 1:2955 N HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-2915
Practice Address - Country:US
Practice Address - Phone:317-293-4020
Practice Address - Fax:317-293-4064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty