| NPI | 1992912919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON C FLANNAGAN Owner 317-867-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12010702A) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |