| NPI | 1609190719 |
|---|---|
| Doing Business As | ELLETTSVILLE GENTLE DENTIST |
| Entity Type | Organization |
| Authorized Contact | JENNIFER PURVIS Ar Manager 317-359-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |