| NPI | 1407996291 |
|---|---|
| Doing Business As | DENTAL FACULTY PRIVATE PRACTICE |
| Entity Type | Organization |
| Authorized Contact | JILL ALLEN Clinic Adminstrator 317-278-6946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223X0008X Dentist, Oral and Maxillofacial Radiology | |
| 291U00000X Clinical Medical Laboratory | |
| 122300000X Dentist | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2010-04-30 |