Organization
SUN GATE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA CARYNTHIA HANES DDS, MSD (PROSTHODONTIST)
(317) 354-7999
Entity
Organization
Contact information
Practice address
3750 LANDMARK DR STE E, LAFAYETTE, IN 47905-6652
(317) 354-7999
Mailing address
5769 WATERSTONE WAY, WHITESTOWN, IN 46075-9001
(131) 735-4799
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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