| NPI | 1629522289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN FERNANDO YEPES Pediatric Dentist 317-938-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12012166A) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |