| NPI | 1114079449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE FORREST HEDRICK Owner 812-883-5804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12005647A) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |