Provider Demographics
NPI:1336345537
Name:NOBLESVILLE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:NOBLESVILLE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-773-1302
Mailing Address - Street 1:455 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1315
Mailing Address - Country:US
Mailing Address - Phone:317-773-1302
Mailing Address - Fax:317-773-4214
Practice Address - Street 1:455 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1315
Practice Address - Country:US
Practice Address - Phone:317-773-1302
Practice Address - Fax:317-773-4214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009722122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty