| NPI | 1386193704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY HARRIS Dentist 765-717-1233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011711a) |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2016-09-27 |