| NPI | 1619412103 |
|---|---|
| Doing Business As | GENTLE FAMILY DENTISTRY AT FORT BEN HARRISON |
| Entity Type | Organization |
| Authorized Contact | MALEK FANSA Dentist/Owner 317-545-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010260A) |
| Enumeration Date | 2016-12-20 |
| Last Update Date | 2016-12-20 |