| NPI | 1295062339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DAVID TSCHETTEI Owner 812-336-5525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12010765) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IN 12010729) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2018-05-17 |