| 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 |