| NPI | 1265662217 |
|---|---|
| Doing Business As | TIPTON PARK DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ADAM DOUGLAS CLOCK Owner/President/Member 812-376-9335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010542A) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2009-07-23 |