| NPI | 1598855041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVON R. COOK President 812-402-3485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12010257A) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |