Most Relevant Information
Provider Data
| NPI Number: | 1003077272 |
| Provider Name: | GENTRY C DODD MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 0116020159 |
Most Important Dates
| Enumeration Date: | 06/20/2008 |
| Last Updated: | 07/07/2014 |
Provider Practice Location
340 W 10TH ST STE 6200
INDIANAPOLIS
IN
462023082
Practice Location Phone/Fax
| Phone: | 3176256141 |
| Fax: |
Provider Mailing Location
340 W 10TH ST STE 6200
INDIANAPOLIS
IN
462023082
Provider Mailing Phone/Fax
| Phone: | 3176256141 |
| Fax: |