| NPI | 1003269598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH A KIRSCH Member 317-809-2411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12011627A) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |