| NPI | 1558893768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK ROBERT YOUNG President 812-639-8443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12011014A) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |