| NPI | 1760916381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNA DAVIES Owner 317-288-5388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12012035A) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-05-11 |