| NPI | 1962502146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS D MENEGOTTO President 317-271-3079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009826) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: IN 12009826) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |