| NPI | 1154526101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUZ-ELENA VALENCIA Dentist 317-865-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009588) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-08-22 |