| NPI | 1922530823 |
|---|---|
| Doing Business As | IMAGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JODY WILSON Dentist/Owner 317-551-8040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IN 12012331A) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |