# ADVANCED DENTAL

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

## Provider details

- **NPI number:** 1528118148
- **Authorized official:** MRS. MARIE IRMA GAMBETTA (SECRETARY)
- **Authorized official phone:** (219) 923-3391

## Contact information

- **Practice address:** 15285 W 101ST AVE, SUITE H, DYER, IN 46311-3035
- **Practice address phone:** (219) 365-5420
- **Practice address fax:** (219) 365-5448
- **Mailing address:** 1801 ORIOLE DR, MUNSTER, IN 46321-3443
- **Mailing address phone:** (219) 923-3391
- **Mailing address fax:** (219) 365-5448

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010023A | IN | Yes |

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 08/22/2020