| NPI | 1417327537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE H EDWARDS Dentist 317-842-8453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12010350A) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-10-01 |