NPI | 1104110923 |
---|---|
Entity Type | Organization |
Authorized Contact | NASSIM FAYEZ OLABI Owner/Pediatric Dentist 765-642-3263 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12010787A) |
Enumeration Date | 2011-06-09 |
Last Update Date | 2014-09-25 |