| NPI | 1992714760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON C. SIMS President 765-642-8286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010503A) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2020-08-22 |