| NPI | 1235386764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND GILBERT HATLAND Owner 317-257-0794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 120069) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2008-08-27 |