Organization
GENTLE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHETT THARP (PRESIDENT)
(812) 339-7371
Entity
Organization
Contact information
Practice address
3929 E 3RD ST, BLOOMINGTON, IN 47401-5554
(812) 339-7371
Mailing address
3929 E 3RD ST, BLOOMINGTON, IN 47401-5554
(812) 339-7371
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8153
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100260280A
—
IN
01
—
1942397567
NPI
—
Enumeration date
06/26/2015
Last updated
06/26/2015
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