| NPI | 1902327059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA FINN Office Manager 317-774-8480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2017-06-29 |