NPI | 1134164445 |
---|---|
Doing Business As | PRIME SMILE WEST |
Entity Type | Organization |
Authorized Contact | HELEN K. PETERSON Owner 317-925-2810 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2006-06-19 |
Last Update Date | 2019-07-01 |