Organization
DENTAL ASSOCIATES WEST, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOYCE GONZALVO ABLOG D.D.S. (PRESIDENT/DENTIST)
(812) 422-1135
Entity
Organization
Contact information
Practice address
5310 PEARL DR, SUITE C, EVANSVILLE, IN 47712-8105
(812) 422-1135
(812) 422-1978
Mailing address
5310 PEARL DR, SUITE C, EVANSVILLE, IN 47712-8105
(812) 422-1135
(812) 422-1978
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009717
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200149940A
—
IN
Enumeration date
11/21/2016
Last updated
11/21/2016
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