| NPI | 1710423280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN CABBELL Office Manager 317-522-0908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12010607A) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2018-07-10 |