| NPI | 1245743327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY COAD Office Manager 317-570-5480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010486) |
| Enumeration Date | 2017-11-10 |
| Last Update Date | 2017-11-10 |