| NPI | 1083102644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA STEVENS Dentist 317-697-9345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12012122A) |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2018-04-28 |