| NPI | 1528370681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LYNN WORTHINGTON President 317-575-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011279A) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2010-07-06 |