| NPI | 1316372113 |
|---|---|
| Doing Business As | WALNUT STREET FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ALLEN ERIKS Owner 765-659-4977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010984A) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2013-09-11 |