| NPI | 1235217027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY WILLIAM STUTLER President 317-852-6620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010504A) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-08-05 |