NPI | 1134845845 |
---|---|
Entity Type | Organization |
Authorized Contact | HENGAMEH MOTEVASEL Owner 317-603-5226 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2022-10-13 |
Last Update Date | 2022-10-13 |