| NPI | 1871847079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R. MOSSER Dentist/Member 317-773-3888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011525) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2012-11-09 |