| NPI | 1881074458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC DEWAYNE PARKER Owner 812-525-2372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12012289A) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2015-06-09 |