NPI | 1326342841 |
---|---|
Doing Business As | ADVANCED DENTISTRY & TMJ |
Entity Type | Organization |
Authorized Contact | MIKE HASHEM DELDAR Owner 317-208-0000 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 12009956A) |
Additional Taxonomies | 122300000X Dentist (Licence: IN 12009956A) |
Enumeration Date | 2010-12-23 |
Last Update Date | 2011-03-21 |