| NPI | 1477931418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MICHAEL PRINCELL Owner / Dentist 317-577-2478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12009143A) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |