| NPI | 1508188590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN DANIELS Owner 812-656-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12011357A) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2020-08-19 |