| NPI | 1518456557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA E FENDER Owner 812-882-7867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12012617A) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-05-04 |