| NPI | 1427495621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN MCWILLIAMS Office Manager 812-477-2836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12010009A) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12006664A) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |