| NPI | 1285847376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISA A WALKER Owner 317-849-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12009571A) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |