# ELLETTSVILLE DENTAL CENTER, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063515914
- **Authorized official:** DAVID C COMPTON (PRESIDENT)
- **Authorized official phone:** (812) 876-7330

## Contact information

- **Practice address:** 5915 WEST HIGHWAY 46, ELLETTSVILLE, IN 47429-0518
- **Practice address phone:** (812) 876-7330
- **Practice address fax:** (812) 876-7325
- **Mailing address:** PO BOX 518, ELLETTSVILLE, IN 47429-0518
- **Mailing address phone:** (812) 876-7330
- **Mailing address fax:** (812) 876-7325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 12/16/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200348440A | — | IN |