| NPI | 1356509731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA P VIERNES Owner 317-329-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12011023A) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12010470A) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |