| NPI | 1962708990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA L FOSS Dentist 317-670-5893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12011323A) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2011-02-09 |