Organization
DENTAL HEALTH ASSOC OF IN
Active
Other names
Ellettsville Gentle Dentist
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PURVIS (AR MANAGER)
(317) 359-3888
Entity
Organization
Contact information
Practice address
3617 W STATE ROAD 46, BLOOMINGTON, IN 47404-9152
(812) 876-0007
Mailing address
3617 W STATE ROAD 46, BLOOMINGTON, IN 47404-9152
(812) 876-0007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/18/2010
Last updated
03/18/2010
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