| NPI | 1134341332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCI MORRISSEY Office Manager 317-237-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009909) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |