| NPI | 1265101356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RUSSELL YANCEY Dentist Anesthesiologist 317-459-0738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2021-09-10 |
| Last Update Date | 2024-04-16 |