| NPI | 1063082725 |
|---|---|
| Former Legal Business Name | SIGNATURE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MATTHEW FRAIZ Dentist Owner 317-872-3465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2021-06-25 |