| NPI | 1447616545 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JAMIE HOLLAND Office Manager 317-271-6060  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 7580)  | 
| Enumeration Date | 2016-01-06 | 
| Last Update Date | 2016-01-06 |