Individual
DR. PHILIP W GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1234 E DUPONT RD, STE 4, FORT WAYNE, IN 46825
(260) 490-3495
(260) 497-0540
Mailing address
1234 E DUPONT RD, STE 4, FORT WAYNE, IN 46825
(260) 490-3495
(260) 497-0540
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12007605B
IN
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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