| NPI | 1841320553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL MCCABE President 812-376-9425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12009978) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2008-03-06 |