| NPI | 1063768471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN BRADLEY HELMS President 765-490-1031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 54001743A) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2012-08-03 |