| NPI | 1356729883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH AKARD WILSON President 317-856-2309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12008962) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2015-05-17 |
| Last Update Date | 2015-05-17 |