| NPI | 1548697592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JUNTGEN Pediatric Dentist 317-965-8850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12011451A) |
| Enumeration Date | 2013-10-06 |
| Last Update Date | 2013-10-06 |