NPI | 1114230919 |
---|---|
Doing Business As | KEYSTONE FAMILY DENTAL CENTER |
Entity Type | Organization |
Authorized Contact | MATTHEW EDWARD CHURCH Owner/Dentist 317-252-5480 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010045) |
Enumeration Date | 2010-07-21 |
Last Update Date | 2010-07-21 |