| NPI | 1194105502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILES D SCHROEDER Dentist 317-897-8028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 7381) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IN 7658) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-06-02 |