| NPI | 1760113534 |
|---|---|
| Doing Business As | KOKOMO FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JACLYN KRISTINE RIDDER Owner 317-418-1342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2022-06-22 |