NPI | 1114949377 |
---|---|
Entity Type | Organization |
Authorized Contact | ALESIA DENISE BROWN President 812-874-2235 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010219a) |
Enumeration Date | 2006-07-24 |
Last Update Date | 2015-06-03 |