# DENTAL HEALTH ASSOC OF IN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ellettsville Gentle Dentist
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609190719
- **Authorized official:** JENNIFER PURVIS (AR MANAGER)
- **Authorized official phone:** (317) 359-3888

## Contact information

- **Practice address:** 3617 W STATE ROAD 46, BLOOMINGTON, IN 47404-9152
- **Practice address phone:** (812) 876-0007
- **Mailing address:** 3617 W STATE ROAD 46, BLOOMINGTON, IN 47404-9152
- **Mailing address phone:** (812) 876-0007

## Taxonomy

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

## Other

- **Enumeration date:** 03/18/2010
- **Last updated:** 03/18/2010