| NPI | 1679922470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS QUILL President 317-881-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 122300000X Dentist | |
| 1223E0200X Dentist, Endodontics | |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2016-06-13 |