| NPI | 1134386386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY E. COWAN Owner/Surgeon 317-536-0748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IN 12009344A) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2019-12-03 |