| NPI | 1528700994 |
|---|---|
| Doing Business As | CENTRAL INDIANA PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | COURTNEY R MONTEITH Credentialing Coordinator 217-540-8306 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-05-25 |