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General NPI Number Information
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NPI Number | 1538085295
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Entity Type | Organization
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Legal Business Name | GOSPORT DENTAL, PC
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 10 E MAIN ST
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City | GOSPORT
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State | IN
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Zip | 47433-7035
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Country | US
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Telephone | 812-879-4216
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Fax | 812-879-4286
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Provider Business Mailing Address
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Address Line | 10 E MAIN ST P.O. BOX 189
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City | GOSPORT
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State | IN
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Zip | 47433-7035
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Country | US
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Telephone | 812-879-4216
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Fax | 812-879-4286
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Authorized Official
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Title or Position | DENTIST
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Name | ALEXIS HECK-BRITTON
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Credential | DDS
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Telephone | 812-821-6210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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