# MARVEL DENTAL DDS PC

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

## Provider details

- **NPI number:** 1679229504
- **Authorized official:** BHAVNEET SINGH (DENTIST)
- **Authorized official phone:** (260) 666-5100

## Contact information

- **Practice address:** 6408 W JEFFERSON BLVD STE D, FORT WAYNE, IN 46804-6204
- **Practice address phone:** (216) 801-2718
- **Mailing address:** 11516 PRATO CV, FORT WAYNE, IN 46845-1385
- **Mailing address phone:** (216) 801-2718

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 03/01/2022
- **Last updated:** 04/16/2024