| NPI | 1811022924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CLARK BEATY President 317-745-7711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IN 12009222A) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IN 12010827A) |
| 1223G0001X Dentist General Practice (Licence: IN 12006829A) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2009-09-02 |