| NPI | 1073067328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN RENEE BOOE Pediatric Dentist 812-847-5101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12012174A) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-10-10 |