Provider Demographics
NPI:1194481382
Name:DOWDEN FAMILY DENTISTRY
Entity type:Organization
Organization Name:DOWDEN FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGE
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-631-0711
Mailing Address - Street 1:9623 WINDERMERE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9181
Mailing Address - Country:US
Mailing Address - Phone:317-594-0461
Mailing Address - Fax:317-594-0477
Practice Address - Street 1:9623 WINDERMERE BLVD STE B
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9181
Practice Address - Country:US
Practice Address - Phone:317-594-0461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental