| NPI | 1689878415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB LEE MASTERS Manager 317-881-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12011008A) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-08-22 |