# DR. L GARY PAINTER PC

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

## Provider details

- **NPI number:** 1639501273
- **Authorized official:** L. GARY PAINTER DDS (OWNER)
- **Authorized official phone:** (260) 486-3100

## Contact information

- **Practice address:** 4109 LAHMEYER RD, FORT WAYNE, IN 46815-5666
- **Practice address phone:** (260) 486-3100
- **Practice address fax:** (260) 486-0068
- **Mailing address:** 4109 LAHMEYER RD, FORT WAYNE, IN 46815-5666
- **Mailing address phone:** (260) 486-3100
- **Mailing address fax:** (260) 486-0068

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12008216A | IN | Yes |
| 122300000X | Dentist | 12011943A | — | — |

## Other

- **Enumeration date:** 08/06/2013
- **Last updated:** 08/06/2013