| NPI | 1063941391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYRAH IMTIAZ QURAISHI Owner 317-998-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IN 12012422A) |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2022-07-21 |