Organization
MALEK FANSA D.D.S., LLC.
Active
Other names
Gentle Family Dentistry at Fort Ben Harrison
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALEK FANSA D.D.S. (DENTIST/OWNER)
(317) 545-6545
Entity
Organization
Contact information
Practice address
9620 E 59TH ST, INDIANAPOLIS, IN 46216-1020
(317) 545-6545
Mailing address
13119 MAYWICK DR, FISHERS, IN 46037-4425
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010260A
IN
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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