| NPI | 1053360479 |
|---|---|
| Doing Business As | THE VILLAGE DENTIST |
| Entity Type | Organization |
| Authorized Contact | TERRY H VIBBERT President 812-424-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12009155) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12010628) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-08-22 |