| NPI | 1679398424 |
|---|---|
| Doing Business As | KIDS & ADULT DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRANDI MARIE BIBB Practice Administrator 317-605-8367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |