| NPI | 1396966099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE PUMPHREY Owner 317-392-1468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010371) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2009-03-03 |