| NPI | 1548703671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE GONZALVO ABLOG President/Dentist 812-422-1135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12009717) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |