| NPI | 1912001447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH R. TROUTMAN Dentist 812-683-2006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 7860) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12010469A) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-08-22 |