| NPI | 1770678864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELLA KWIATKOWSKI Office 317-839-8191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 7001) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |