Provider Demographics
NPI:1629863089
Name:WILLIAM C. TELLMAN, DDS, PC
Entity type:Organization
Organization Name:WILLIAM C. TELLMAN, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:TWLLMN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-849-3280
Mailing Address - Street 1:5750 E 91ST ST STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1380
Mailing Address - Country:US
Mailing Address - Phone:317-894-3280
Mailing Address - Fax:317-849-3868
Practice Address - Street 1:5750 E 91ST ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1380
Practice Address - Country:US
Practice Address - Phone:317-894-3280
Practice Address - Fax:317-849-3868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty