# MAPLE DENTAL DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MAPLE DENTAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609606185
- **Authorized official:** DR. GURPREET KAUR DDS (DENTIST)
- **Authorized official phone:** (347) 445-3453

## Contact information

- **Practice address:** 6418 EST STATE BOULEVARD, STORE \#23, FORTWAYNE, IN 46815
- **Practice address phone:** (260) 601-3300
- **Practice address fax:** (833) 563-2510
- **Mailing address:** 14207 KIDD CREEK CROSSOVER, FORT WAYNE, IN 46845-0180
- **Mailing address phone:** (216) 801-2718

## Taxonomy

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

## Other

- **Enumeration date:** 08/07/2024
- **Last updated:** 04/23/2025