| NPI | 1326783721 |
|---|---|
| Doing Business As | INDY EAST PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | BRITTANY LANE Owner 317-357-2235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-04-29 |