Individual
BRYAN GANTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
124 N INDIANA ST, MOORESVILLE, IN 46158-1503
(317) 831-3370
Mailing address
677 E MERRILL ST, INDIANAPOLIS, IN 46203-1727
(574) 206-5689
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12014126A
IN
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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