| NPI | 1083037782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIANA KANO-WILSON Co Owner 812-372-6165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011382) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2014-01-31 |