| NPI | 1265222103 |
|---|---|
| Former Legal Business Name | INDIANAPOLIS ORAL SURGERY AND DENTAL IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | JACKIE HOLLOWAY Director Of Rcm 854-200-7970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |