Provider Demographics
NPI:1871204404
Name:BENJAMIN D AHLBRECHT DDS PC
Entity type:Organization
Organization Name:BENJAMIN D AHLBRECHT DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:AHLBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-617-0014
Mailing Address - Street 1:8902 N MERIDIAN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5306
Mailing Address - Country:US
Mailing Address - Phone:317-571-5000
Mailing Address - Fax:317-571-5010
Practice Address - Street 1:8902 N MERIDIAN ST STE 102
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5306
Practice Address - Country:US
Practice Address - Phone:317-571-5000
Practice Address - Fax:317-571-5010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental