| NPI | 1457620783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIAN H KELLY Owner/Dentist 812-683-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011133A) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2018-08-22 |