| NPI | 1922587351 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ANITA GILMAN Office Manager 812-238-1908 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009095) | 
| Enumeration Date | 2018-08-07 | 
| Last Update Date | 2018-08-07 |