| NPI | 1558857540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY THURMAN Office Manager 317-842-8453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12010349A) |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2018-07-03 |