| NPI | 1679797153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON HALEY Dentist 317-736-6361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12008791) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12010199) |
| 1223G0001X Dentist, General Practice (Licence: IN 12009943) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |