| NPI | 1881066959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT MENDOZA Office Manager 317-581-1280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12010273a) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |