| NPI | 1790300242 |
|---|---|
| Doing Business As | DECATUR WOODS DENTAL |
| Entity Type | Organization |
| Authorized Contact | JOHNATHON M KELLER Dentist 317-946-4464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |