NPI | 1962519769 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY TAYLOR WRIGHT Dentist 317-897-6074 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12008771) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12010081A) |
1223G0001X Dentist, General Practice (Licence: IN 12007835) | |
Enumeration Date | 2006-08-25 |
Last Update Date | 2020-08-22 |