| NPI | 1962154732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK EDWIN SHERER President/General Dentist 317-634-8440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2022-01-24 |