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Organization
DENTAL HEALTH ASSOC OF IN
Active
Organization
DENTAL HEALTH ASSOC OF IN
Active
Other names
Ellettsville Gentle Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PURVIS (AR MANAGER)
(317) 359-3888
Entity
Organization
Contact information
Practice address
3617 W STATE ROAD 46, BLOOMINGTON, IN 47404-9152
(812) 876-0007
Mailing address
3617 W STATE ROAD 46, BLOOMINGTON, IN 47404-9152
(812) 876-0007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/18/2010
Last updated
03/18/2010
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