| NPI | 1396869087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN M AHLERS Owner 317-787-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12005572) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |