| NPI | 1306948419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WILLIAM BLACKBURN Dentist 812-402-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IN 12010141A) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IN 12010139A) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-08-22 |