| NPI | 1912161019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT E. MANN Owner 317-882-1536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12009166) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |