# SUN GATE DENTAL

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

## Provider details

- **NPI number:** 1205606670
- **Authorized official:** DR. BRENDA CARYNTHIA HANES DDS, MSD (PROSTHODONTIST)
- **Authorized official phone:** (317) 354-7999

## Contact information

- **Practice address:** 3750 LANDMARK DR STE E, LAFAYETTE, IN 47905-6652
- **Practice address phone:** (317) 354-7999
- **Mailing address:** 5769 WATERSTONE WAY, WHITESTOWN, IN 46075-9001
- **Mailing address phone:** (131) 735-4799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2024
- **Last updated:** 01/05/2024