Provider Demographics
NPI:1952496721
Name:ZIONSVILLE ORTHODONTICS, P.C.
Entity Type:Organization
Organization Name:ZIONSVILLE ORTHODONTICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:317-852-5566
Mailing Address - Street 1:18 BOULEVARD MOTIF
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112
Mailing Address - Country:US
Mailing Address - Phone:317-852-5566
Mailing Address - Fax:317-852-3527
Practice Address - Street 1:1455 WEST OAK STREET
Practice Address - Street 2:SUITE A
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077
Practice Address - Country:US
Practice Address - Phone:317-873-5566
Practice Address - Fax:317-873-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120074571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty