NPI | 1033274071 |
---|---|
Doing Business As | BOURBON FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | NICOLE LYNN CHRISTY Owner 574-342-4385 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2006-12-27 |
Last Update Date | 2008-07-15 |