| NPI | 1518054428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG C MAZONAS President 317-392-3231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12008860A) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2008-08-06 |