# INDIANA DENTAL CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brownstown Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952404337
- **Authorized official:** MR. FENNIS BLEDSOE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (765) 292-2366

## Contact information

- **Practice address:** 615 W COMMERCE ST, BROWNSTOWN, IN 47220
- **Practice address phone:** (812) 358-5950
- **Practice address fax:** (812) 358-2062
- **Mailing address:** PO BOX 38, BROWNSTOWN, IN 47220
- **Mailing address phone:** (812) 358-5950
- **Mailing address fax:** (812) 358-2062

## Taxonomy

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

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 08/22/2020