| NPI | 1689049173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET C CLARK Partner 317-271-9727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12008748) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: IN 12007616) |
| 261QD0000X Clinic/Center, Dental (Licence: IN 12008253) | |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |