| NPI | 1366531196 |
|---|---|
| Former Legal Business Name | INDY DENTAL GROUP, LLC |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH B LEWIS Owner 317-571-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009479) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2014-01-01 |