| NPI | 1811337538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC L HERMAN Owner 812-882-1572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12010409A) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |