| NPI | 1205268711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA CREAMER Office Manager 812-945-2760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IN 12008221) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2014-06-02 |