Provider Demographics
NPI:1649343237
Name:ISAAC, ERROL EUGENE JR (DDS)
Entity type:Individual
Prefix:DR
First Name:ERROL
Middle Name:EUGENE
Last Name:ISAAC
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6058 E 82ND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1530
Mailing Address - Country:US
Mailing Address - Phone:317-436-7341
Mailing Address - Fax:
Practice Address - Street 1:3709 E WASHINGTON ST
Practice Address - Street 2:J
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-4429
Practice Address - Country:US
Practice Address - Phone:317-362-7893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010947A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist