Organization
ELLETTSVILLE DENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C COMPTON (PRESIDENT)
(812) 876-7330
Entity
Organization
Contact information
Practice address
5915 WEST HIGHWAY 46, ELLETTSVILLE, IN 47429-0518
(812) 876-7330
(812) 876-7325
Mailing address
PO BOX 518, ELLETTSVILLE, IN 47429-0518
(812) 876-7330
(812) 876-7325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200348440A
—
IN
Enumeration date
09/06/2006
Last updated
12/16/2010
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