| NPI | 1376037853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY A TAYLOR Owner 317-418-3848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12012151A) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2018-06-19 |