| Ellettsville Dental Center, Inc. | |
|
5915 West Highway 46 Ellettsville IN 47429-0518 | |
| (812) 876-7330 | |
| (812) 876-7325 |
| Full Name | Ellettsville Dental Center, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5915 West Highway 46, Ellettsville, Indiana |
| Authorized Official Name and Position | David C Compton (PRESIDENT) |
| Authorized Official Contact | 8128767330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellettsville Dental Center, Inc. Po Box 518 Ellettsville IN 47429-0518 Ph: (812) 876-7330 | Ellettsville Dental Center, Inc. 5915 West Highway 46 Ellettsville IN 47429-0518 Ph: (812) 876-7330 |
| NPI Number | 1063515914 |
|---|---|
| Provider Enumeration Date | 09/06/2006 |
| Last Update Date | 12/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063515914 | NPI | - | NPPES |
| 200348440A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |