Provider Demographics
NPI:1558754788
Name:BALL DENTISTRY, PC
Entity Type:Organization
Organization Name:BALL DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:E
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:317-846-3463
Mailing Address - Street 1:9595 WHITLEY DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1311
Mailing Address - Country:US
Mailing Address - Phone:317-846-3463
Mailing Address - Fax:
Practice Address - Street 1:9595 WHITLEY DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1311
Practice Address - Country:US
Practice Address - Phone:317-846-3463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011835A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN=========OtherTIN