Provider Demographics
NPI:1982464509
Name:ABIGAIL H MITCHELL, DDS, LLC
Entity Type:Organization
Organization Name:ABIGAIL H MITCHELL, DDS, LLC
Other - Org Name:AVON FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-272-7715
Mailing Address - Street 1:7318 E US HIGHWAY 36 STE 100
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-6882
Mailing Address - Country:US
Mailing Address - Phone:317-272-7715
Mailing Address - Fax:
Practice Address - Street 1:7318 E US HIGHWAY 36 STE 100
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6882
Practice Address - Country:US
Practice Address - Phone:317-272-7715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty