| NPI | 1700223732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE T. FARTHING Owner 317-882-7694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12007985A) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12011645A) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2013-09-12 |