| NPI | 1700639390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE E FERRY Owner 812-350-4465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-04-11 |