| NPI | 1447415294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE D HEFLIN Dentist President 317-573-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12008323A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 120104078) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-07-22 |