| NPI | 1467735332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LADD CEO 765-455-0085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12010856A) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-09-27 |