NPI | 1902457039 |
---|---|
Doing Business As | SPEEDWAY PEDIATRIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | DILLON T WILEY Dentist / Owner 317-695-3604 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2019-09-20 |
Last Update Date | 2020-07-21 |