| NPI | 1891350575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JACOB DEVITT Owner/Oral Surgeon 812-332-2204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2019-05-07 |