| NPI | 1477961746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA TAYLOR Owner/Dentist 317-968-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: IN 12011023A) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2014-07-30 |