| NPI | 1801295886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLAN BARR Owner 812-372-5101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12009846A) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2014-08-15 |