| NPI | 1396718185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A. PANGALLO Dentist 317-280-1211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: IN #6629A) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-08-22 |