| NPI | 1316984669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D. HENNETTE President 317-271-9727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12008394A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12008107A) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-08-08 |