| NPI | 1457628711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE E. MCFERRAN Front Office 765-649-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12008702) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |