Provider Demographics
NPI:1740842681
Name:POTEE FAMILY DENTISTRY
Entity type:Organization
Organization Name:POTEE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POTEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-385-7976
Mailing Address - Street 1:1540 CONNER ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-2914
Mailing Address - Country:US
Mailing Address - Phone:317-773-0883
Mailing Address - Fax:317-770-6070
Practice Address - Street 1:1540 CONNER ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2914
Practice Address - Country:US
Practice Address - Phone:317-773-0883
Practice Address - Fax:317-770-6070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental