NPI | 1629415419 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANNE E. DEAN Member, LLC / Office Manager 812-425-4251 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12006932A) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12011866A) |
Enumeration Date | 2013-06-03 |
Last Update Date | 2013-06-03 |