| NPI | 1255837860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY THURMAN Office Manager 317-842-8453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010349A) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2019-03-12 |