| NPI | 1033659487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK M MILLER Owner 317-571-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009482A) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |