| NPI | 1063614220 |
|---|---|
| Doing Business As | INTEGRATIVE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL KEVIN GOSSWEILER President 317-329-9291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IN 12008973) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |