| NPI | 1629911383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MCCULLUM Orthodontist 812-213-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2026-04-09 |
| Last Update Date | 2026-04-09 |