| NPI | 1184800443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW R LANE Owner 317-581-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010414A) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2008-01-17 |