| NPI | 1841323870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE E TAUBE Secretary Of Corp. 317-632-6258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 54000394A) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |