Provider Demographics
NPI:1730359902
Name:HEARN FAMILY DENTISTRY P.C.
Entity type:Organization
Organization Name:HEARN FAMILY DENTISTRY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-867-0808
Mailing Address - Street 1:5570 PEBBLE VILLAGE LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-7423
Mailing Address - Country:US
Mailing Address - Phone:317-867-0808
Mailing Address - Fax:
Practice Address - Street 1:5570 PEBBLE VILLAGE LN
Practice Address - Street 2:SUITE 100
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-7423
Practice Address - Country:US
Practice Address - Phone:317-867-0808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120098671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty