NPI | 1801838321 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY HIESTER Dentist 812-479-8609 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12010159A) |
Enumeration Date | 2006-06-11 |
Last Update Date | 2007-09-12 |