Provider Demographics
NPI:1689832537
Name:GARVIN, WENDY JEAN (DDS)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:JEAN
Last Name:GARVIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 E 146TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033
Mailing Address - Country:US
Mailing Address - Phone:317-581-0000
Mailing Address - Fax:317-846-7717
Practice Address - Street 1:2750 E 146TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033
Practice Address - Country:US
Practice Address - Phone:317-581-0000
Practice Address - Fax:317-846-7717
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010088A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice