NPI | 1083820062 |
---|---|
Entity Type | Organization |
Authorized Contact | DEANA MCCLIMON Office Manager 317-780-7777 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010497A) |
Enumeration Date | 2007-05-15 |
Last Update Date | 2019-06-28 |