| NPI | 1013952696 |
|---|---|
| Doing Business As | PRIME SMILE EAST |
| Entity Type | Organization |
| Authorized Contact | HELEN K. PETERSON Owner 317-322-1840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2019-06-24 |