Organization
MINI DENTAL IMPLANT CENTERS OF AMERICA LLC
Active
Parent organization
YORKTOWN FAMILY DENTISTRY INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
YORKTOWN FAMILY DENTISTRY INC
Authorized official
STEPHEN J GANT DDS (DENTIST)
(765) 759-8351
Entity
Organization
Contact information
Practice address
2001 S TIGER DRIVE, YORKTOWN, IN 47396
(765) 759-8351
(765) 759-8749
Mailing address
2001 S TIGER DRIVE, YORKTOWN, IN 47396
(765) 759-8351
(765) 759-8749
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12007237
IN
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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