| NPI | 1477018232 |
|---|---|
| Doing Business As | GLACIER PEAK DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | ERIC APPELSIES President 317-270-0903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2019-09-05 |