| NPI | 1912335464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED REESE President 317-882-0228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12008609A) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2013-10-21 |