| NPI | 1356771323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO A NEIRA Dentist/Owner 317-246-9544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 28589) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: TX 28589) |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2022-07-21 |