Broad Ripple Family Dental, LLC

NPI #1073840393 in Indianapolis, Indiana

Provider Information

NPI Number: 1073840393
Entity Type: Organization
Organization Name: Broad Ripple Family Dental, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 6, 2009
Last Updated: Nov 6, 2009

Practice Location

Address: 6117 N COLLEGE AVE
City: Indianapolis
State: Indiana
ZIP Code: 46220-2233
Phone: (317) 257-3368

Authorized Official

Name: DR. GINA ELROD
Title: DENTIST
Phone: (317) 257-3368

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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