| NPI | 1568891604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELA JEANETTE LAWSON President/Owner 317-770-4783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12007812A) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2015-07-23 |