| NPI | 1144676123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MICHAEL MONTES Sole Proprietor 317-257-5442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |