| NPI | 1922805969 |
|---|---|
| Doing Business As | CENTER GROVE FAMILY DENTISTRY LLC |
| Entity Type | Organization |
| Authorized Contact | KRISTIN STEVENS Owner/Dentist 317-548-2627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-02-27 |
| Last Update Date | 2025-02-27 |