| NPI | 1205467511 |
|---|---|
| Doing Business As | SOUTHERN INDIANA DENTAL |
| Entity Type | Organization |
| Authorized Contact | ADRIENNE NICHOLSON Regional Manager 812-569-2955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2020-01-27 |