| NPI | 1982078853 |
|---|---|
| Doing Business As | GREAT LAKES FAMILY DENTAL GROUP-INDIANAPOLIS |
| Entity Type | Organization |
| Authorized Contact | PATRICIA J HART Corporate Manager 317-841-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |