| NPI | 1275690166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN EARL BLAKELY General Dentist Owner 317-257-3799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 7840) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2008-07-14 |