| NPI | 1881843613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD MITCHELL WHITLOCK President 812-332-0052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009170) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2012-02-17 |