| NPI | 1174534515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D BENNETT President Surgeon 317-849-3667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12007758) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2012-10-29 |