| NPI | 1558494658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC JASON ARNOLD Owner 765-286-3116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12010040A) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 54000436) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2014-08-28 |