| NPI | 1508175928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELAYNE MARIE LEFEVRE President 317-867-3335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 10831) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2010-10-04 |